Spermatocele is a fluid-filled cyst that develops at the top of the testicle of the epididymis. The fluid is usually a clear or milky white color and may contain sperm. Spermatoceles are typically filled with spermatozoa and they can vary in size from several millimeters to many centimeters. Small spermatoceles are relatively common, occurring in an estimated 30 percent of males. They are generally not painful. However, some people may experience discomfort such as a dull pain in the scrotum from larger spermatoceles. They are not cancerous, nor do they cause an increased risk of testicular cancer. Additionally, unlike varicoceles, they do not reduce fertility. History "Spermatocele" is originally derived from the Greek term spermatos (sperm) and kele (cavity or mass). Oftentimes, "epididymal cyst" has been used interchangeably with "spermatocele." However, it is important to note their differences. Epididymal cysts may appear anywhere along or within the epididymis and do not contain sperm, whereas spermatoceles may contain sperm. Epididymal cysts have been shown to occur more frequently in children before reaching puberty. Epidemiology Spermatoceles usually affect men who are middle-aged and can, although rarely, affect children during puberty. The incidence rate is around 5-20% for children. It is estimated that approximately 30 percent of men have been diagnosed with small spermatoceles while less have larger spermatoceles. The incidence of spermatoceles increases as men age. Before puberty, children from the male sex may develop a similar benign mass called epididymis cyst. Although both epididymis cyst and spermatocele may be referred as the same, the epididymis cyst does not contain sperm and it can occur anywhere within the epididymis. It can be differentiated through an ultrasound imagining. Epididymis cysts larger than 10mm in diameter are recommended for surgery but if there is no problem then surgery is discouraged as it can affect fertility in the future. Chronic infectious epididymitis Chronic infectious epididymitis is rare. Some signs and symptoms include localized tenderness and swelling in the epididymis, which are different from any tenderness/abnormality present in the testis, these are usually not found in lower urinary tract. Chronic infectious epididymitis may be diagnosed in healthy adolescents as well as men. Some factors that predispose individuals to chronic infectious epididymitis include sexual activity, heavy physical exertion, and bicycle or motorcycle riding. Those diagnosed with chronic or recurrent epididymitis should receive a CT scan with contrast and a prostate ultrasonography to rule out structural abnormality of