What is the difference between a hydrocele and a spermatocele?

Anatomic: Spermatoceles are sacs often filled with sperm that herniate out from the spermatic cord or epididymis. Hydroceles are fluid sacs in the tissue that surrounds the testicle. On examination, a spermatocele often feels like a separate structure whereas a hydrocele feels more like a very enlarged testicle.

Embryonic origins: A hydrocele develops from an out pouching of the peritoneum (lining of the abdominal cavity) as it follows the testis into the scrotum during fetal development. It is filled with clear fluid. A spermatocele develops off the tubules leading to the testis and is also filled with clear fluid and sperm. Clinically it can be hard to differentiate between them.

Different structures: A hydrocele is a fluid collection around the testicle. A spermatocele is a fluid collection or cyst arising from the epididymis. Both condition are generally benign.

Big difference: A hydrocele is fluid around the testicle. Normally, there is some fluid around the testicle to protect it. Excessive fluid is referred to as a hydrocele which can reach the size of a grapefruit. A spermatocele is usually smaller and is along the path of the epidydimis or vas deferens. Occasionally, they can cause pain. Most are asymptomatic and do not require treatment.