Epididymal cyst removal (spermatocele) is a procedure to remove cysts (fluid-filled sacs under the skin) from the testicular region. An alternative to the surgery is to drain the fluid with a needle; however, the fluid usually refills the cyst after a month or two. Treatment: A surgeon administers general anesthesia, putting the patient to sleep before the procedure.
Thereafter, the surgeon makes an incision in the area, removes the cyst, and sutures the opening shut. Although they are typically benign, the surgeon might have the cyst and fluid examined. Epididymal cyst removal is fairly quick, and most patients are able to go home after a few hours of recovery in the hospital.
Rest, antibiotics, and pain medication are usually recommended once the patient is released. Full recovery may take 7 to 10 days.
Epididymal cyst removal is a relatively minor outpatient surgery, although most males would argue that no surgery in that area is minor. Still, some patients may not be candidates. Smokers and overweight patients are at risk. Similarly, men with blood pressure, heart, or lung problems should check with their doctors before pursuing the removal. While patients can expect mild bruising or swelling, the greatest risk during the procedure is usually the general anesthesia, which may affect the heart or lungs.
Treatment
Small cysts are best left alone, as are larger cysts that are asymptomatic. Only when the cysts are causing discomfort and are enlarging in size, or the patient wants the spermatocele removed, should a spermatocelectomy be considered. Pain may persist even after removal.
Spermatocelectomy can be performed on an outpatient basis, with the use of local or general anesthesia.
Surgical Procedure
Prior to epididymal cyst removal surgery, healthcare professionals advise the patient to stop smoking. Checks are also made on the patient's previous medical history, weight, blood pressure, heart and lung function, medication, and allergies. Epididymal cyst removal surgery is performed under general anesthesia.
The surgeon removes the cyst through a small cut in the scrotum and the incision is closed using dissolving stitches. The procedure takes around 15 to 20 minutes and the cyst is sent to a laboratory for examination. The patient can return home the same day. While epididymal cyst removal surgery is effective in removing cysts, they may occasionally recur.
Diagnosis
Spermatoceles can be discovered as incidental scrotal masses found on physical examination by a physician. They may also be discovered by self-inspection of the scrotum and testicles.
Finding a painless, cystic mass at the head of the epididymis, that transilluminates and can be clearly differentiated from the testicle, is generally sufficient. If uncertainty exists, ultrasonography of the scrotum can confirm if it is spermatocele.
Consult a urologist.
Risk
General Anaesthetic.You may feel normal soon after you wake, but you will be drowsy and your
reactions sluggish for twenty four to forty eight hours.
Bleeding. There is a small risk of bleeding during the operation.
Pain.Take pain killers as necessary if you experience any pain or discomfort in your testicle following the operation.
Infection. If you notice increased pain, swelling, heat or redness around your wound, a discharge (pus), or if you develop a temperature, you should visit your GP immediately as infection may be present, which may require antibiotics.
Swelling and bruising.You may find that the area around the operation site appears swollen and slightly bruised. This should settle after1to 2 weeks.
Failure to improve symptoms of pain.
Scar tissue. Scar tissue caused by the surgery can occasionally block some of the narrow tubes of the epididymis and may affect fertility on that side.
Recurrence of cysts at a later date on either testicle.
Complications
This is when problems occur during or after the operation. Most men are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of epididymal cyst surgery are uncommon, but can include : -
bleeding inside your scrotum (haematoma) - you may need further surgery to stop the bleeding and drain the area
difficulty in passing urine - you may need a temporary catheter to help drain the urine from your bladder
damage to spermatic cord - this can lead to the testicle shrinking and cause fertility problems
damage to the vas deferens (the tube that carries sperm from the testicle) - this can lead to fertility problems
recurrence - the epididymal cysts or the spermatoceles may come back
FAQs
Q. Are epididymal cysts cancerous or will they turn into cancer ?
Epididymal cysts are filled with harmless fluid and not cancerous. They won't turn into cancer if left untreated. Epididymal cysts are located in the sperm-collecting tubes which are folded into a 'crescent shape' at the back of your testicles (the epididymis). This is positioned away from the testis. The testis is where all testicular cancers usually occur.
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Thereafter, the surgeon makes an incision in the area, removes the cyst, and sutures the opening shut. Although they are typically benign, the surgeon might have the cyst and fluid examined. Epididymal cyst removal is fairly quick, and most patients are able to go home after a few hours of recovery in the hospital.
Spermatocelectomy can be performed on an outpatient basis, with the use of local or general anesthesia.
The surgeon removes the cyst through a small cut in the scrotum and the incision is closed using dissolving stitches. The procedure takes around 15 to 20 minutes and the cyst is sent to a laboratory for examination. The patient can return home the same day. While epididymal cyst removal surgery is effective in removing cysts, they may occasionally recur.
Finding a painless, cystic mass at the head of the epididymis, that transilluminates and can be clearly differentiated from the testicle, is generally sufficient. If uncertainty exists, ultrasonography of the scrotum can confirm if it is spermatocele.
Consult a urologist.
