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Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Spermatocele


Text Only Home | Graphic-Rich Site | Overview | Risk and Causation | Diagnosis | Treatment | Prognosis | Differential Diagnosis | Specialists | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Failure to Recover | Medical Codes | References

Medical Codes

ICD-9-CM:
608.1 - Other Disorders of Male Genital Organs, Spermatocele

Related Terms

  • Cystic Tumor of the Epididymis
  • Spermatic Cyst

Overview

Image Description:
Spermatocele - The lower trunk and abdomen of a male figure are shown in profile revealing the ductus deferens leading to the seminal vesicle. The epididymus or sperm duct of the testical depicts a spermatocele within the scrotal sac.
Click to see Image

A spermatocele is a collection of sperm and fluid (cyst) found within the scrotal sac. It can occur at any location along the epididymis. An individual with this condition may have one or multiple spermatoceles. The underlying cause of a spermatocele is uncertain but probably results from obstruction in the epididymal ducts leading from the testicle.

Spermatoceles usually lie behind and just above the testicle but are separate from it. They may be very small or may grow as large as a few inches. Spermatoceles are harmless. There is no indication that they could evolve into a more serious condition. However, in some instances, the spermatocele may become painful or large enough to require surgery.

Incidence and Prevalence: A spermatocele is a common condition, although the precise frequency has not been documented. Spermatoceles are found, however, in 30% of asymptomatic individuals having scrotal ultrasound (ultrasonography) for other reasons (Alsikafi).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Spermatoceles typically appear after puberty and reach maximum incidence during the fourth and fifth decades of life. Sperm leakage into the scrotal sac due to trauma, prior vasectomy, or infection of the sperm ducts (epididymis) may be responsible for the formation of a spermatocele. However, they often occur in the absence of these events.

Source: Medical Disability Advisor



Diagnosis

History: The individual may report the presence of one or more lumps above one or both testicles. They may be accompanied by mild discomfort. However, spermatoceles are often painless and are found incidentally on self-examination or on routine palpation by a physician.

Physical exam: Examination of a spermatocele reveals a semi-firm mass that is round, cystic, and slightly compressible. The mass is located just above and separate from the testicle. Most spermatoceles are unrelated to other medical problems or anatomical abnormalities.

Tests: A light may be held behind the scrotum (transillumination) and high frequency sound waves applied (ultrasound) to determine the exact location and consistency (fluid or solid) of the mass. Fluid may be aspirated from the spermatocele, examined, and cultured to determine if the cyst is sterile.

Source: Medical Disability Advisor



Treatment

No treatment is necessary unless the mass is painful or large enough to warrant surgical removal. Shrinkage of the cyst may be accomplished with aspiration of fluid from the spermatocele. Some urologists caution against the use of needle aspiration, however, fearing that it may lead to infection, spillage of sperm within the scrotum, and consequent reaccumulation of the spermatocele.

The surgical options consist of either injecting an irritant into the spermatocele (sclerotherapy) or the surgical removal of the spermatocele (spermatocelectomy). These procedures can be done on an outpatient basis.

Source: Medical Disability Advisor



Prognosis

Spermatoceles normally do not cause either short- or long-term problems. Sexual function and fertility are not affected. If the cyst becomes large enough to cause symptoms, it can be surgically removed (spermatocelectomy), or the patient can undergo sclerotherapy. The success rate for sclerotherapy varies between 30% and 100%, depending on the sclerosing agent used and the number of treatments required (Alsikafi). The long-term outlook using spermatocelectomy is excellent.

Source: Medical Disability Advisor



Differential Diagnosis

Source: Medical Disability Advisor



Specialists

  • Urologist

Source: Medical Disability Advisor



Comorbid Conditions

Source: Medical Disability Advisor



Complications

The presence of a spermatocele should not allay the concerns of the treating physician until other pathologic conditions within the scrotum or testis are ruled out. A spermatocele may mask the presence of a cancerous (malignant) testicular tumor as well as a hydrocele, a varicocele, an inguinal hernia, epididymitis, orchitis, a hematocele, or torsion of the testis.

Source: Medical Disability Advisor



Factors Influencing Duration

The length of disability is influenced by the need for treatment, the type of treatment, the individual's response to treatment, and any complications that may occur.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Lifting and physical activity may be restricted if surgical removal of the spermatocele is required.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have a history of trauma to the testicles, vasectomy, or infection of the sperm ducts (epididymis)?
  • Are there one or more lumps above one or both testicles?
  • Are these lumps accompanied by mild discomfort?
  • Were transillumination and ultrasound done to determine the exact location of the mass? Was the mass fluid or solid?
  • Was fluid withdrawn (aspirated) from the spermatocele and cultured to determine if the cyst is infected with bacteria?
  • Was the diagnosis of spermatocele confirmed?

Regarding treatment:

  • Was fluid withdrawn (aspirated) from the spermatocele, resulting in shrinkage of the cyst?
  • Did needle aspiration successfully shrink the cyst?
  • Was surgical excision (spermatocelectomy) required due to the size of the cyst or because the cyst was causing significant discomfort?
  • Was surgical excision successful?
  • Did any complications occur as a result of surgery?

Regarding prognosis:

  • Is this an initial diagnosis or a recurrence of a spermatocele?
  • If symptoms have persisted or worsened despite treatment, have other causes been considered?
  • Has individual been compliant with the treatment regimen?
  • Is it possible that the spermatocele has concealed a cancerous (malignant) testicular tumor?

Source: Medical Disability Advisor



References

Cited

Alsikafi, Nejd F., and Dimitri Kuznetsov. "Spermatocele." eMedicine. Eds. Allen Donald Seftel, et al. 9 Sep. 2004. Medscape. 29 Dec. 2004 <http://emedicine.com/med/topic2880.htm>.

Source: Medical Disability Advisor