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Removal of an epididymal cyst is a surgical method for treating cystic-type formations in the scrotal cavity.
Surgical manipulations consist in the elimination of cystic formation through the use of a laser beam or a scalpel.
In medicine, an epididymal cyst is called a spermatocele. Education is a tissue bag of the correct form with a liquid, which mainly consists of spermatozoa. More often education is visualized in the left testicle. On the left, the cyst is always large and easy to determine by palpation.
Indications for removal of an epididymal cyst
Most often, education is detected during preventive examinations. If the development and growth of the cyst is not observed, it is not at all necessary to resort to surgical intervention, since without growth dynamics it is not dangerous to the life and health of the patient.
The operation is prescribed in the presence of growth dynamics of the cystic formation, when there is pressure on the testicle along with pain. The formation of an operable type is characterized by the following features: the scrotum has noticeably increased in size; a sharp pain is felt in the lower abdomen and in the testicles; inside the scrotum, a seal is clearly palpable; with infertility; in the presence of disorders of sexual functions; the presence of signs of impaired blood supply to the testicles; discomfort and swelling are visualized in the groove area; on the face and in the groin there is an increase in hair growth.
Before the operation, the surgeon determines the localization of the cyst and its size through the use of visual inspection and palpation.
If it is difficult to determine the necessary parameters and the location of the formation using simple methods, the patient is referred for an ultrasound of the scrotum.
Testicular cyst removal algorithm
Before proceeding with the cyst excision procedure, each patient undergoes a preoperative examination, which includes the following procedures and consultations: consultation with an anesthesiologist, dentist, otorhinolaryngologist; electrocardiography; OAM; determination of Rh affiliation and blood type; blood test for hepatitis, HIV and RW; coagulogram; UAC.
There are several methods of carrying out the procedure: surgical intervention and punctures in the scrotum. Surgery can be performed using a laser or a scalpel. The algorithm of the procedure does not change from the selected tool. Recently, surgeons prefer the laser, as the operation is carried out quickly, without blood, safely and eliminates infection.
The procedure can be performed under general or local anesthesia. Local anesthesia is used in patients over 14 years of age with a small cystic mass. The duration of the procedure is up to 40 minutes. If the formation is large or there is a whole group of cysts localized in both testicles, then the procedure is performed under general anesthesia. With polycystic disease of both testicles, the surgeon makes an incision in the middle of the scrotum, and if only one testicle is affected, then the incision is made on the side or directly above the formation.
The surgeon coagulates the blood vessels, through the resulting incision, the appendage is removed outward along with the cyst. It is important that maximum sterility is ensured, since there is a high probability of infection entering the scrotum. The cyst is carefully peeled off without a laser or scalpel (if possible) so as not to accidentally damage the appendage. After exfoliation, the appendage and vessels are ligated, then excision is performed. At the site of excision, self-absorbable sutures are applied.
With a large size of the formation, it is not taken out, but all manipulations are carried out blindly or under an ultrasound machine. Actions are carried out by analogy, only for convenience, carbon dioxide is pumped into the scrotum. After the operation, the excised cyst tissue and fluid are sent for laboratory testing in order to determine the nature of the cyst as accurately as possible. The highly stretched scrotal tissues are specially sutured to give it a natural and aesthetic appearance. The incision is sutured, the wound is treated with an antiseptic and covered with an antibacterial plaster. An ice pack is applied to the groin area and lower abdomen – a sharp pain syndrome is removed.
Sclerotherapy instead of surgery
If the cystic formation is small, and the patient has poor blood clotting, the sclerotherapy method is used.
The scrotum in the area of the formation is pierced with a needle with a tube at the end, through which fluid will flow by gravity.
Further, through the same needle, a special adhesive solution is introduced into the cystic sac, which will glue the walls and prevent the sac from filling up again. This procedure is carried out only in extreme cases, since its result is usually a partial or complete loss of reproductive functions.
Rehabilitation after excision
The operation to remove an ovarian cyst is quite simple if the disease is identified in the early stages and the procedure is performed by an experienced surgeon. The recovery period usually lasts 2-7 days, after which discomfort and pain disappear. The doctor prescribes a 10-day antibiotic therapy to the patient for prevention.
The wound heals completely in 3 weeks. During this period, it is important to refrain from sexual intercourse, from physical exertion, visiting saunas and baths, and hypothermia. The first week after the procedure should be carried out in the rhythm of “Bed rest”, so as not to provoke swelling of the scrotum. Underwear should be chosen free in the first week, and in the following days it is important to use special, compression.
Prevention of ovarian cysts
It is important to regularly visit a urologist for examination, these manipulations will determine the presence of a neoplasm in the early stages. Preventive examinations are recommended to be carried out once every six months, at least once a year. It is recommended to visit a urologist in such cases: the impact of radiation and toxins on the body; heredity; oncological formations; scrotum injury; transferred inflammatory processes of the genital organs and STDs.