Name of the Procedure:

Excision of Local Lesion of Epididymis
(Commonly known as Epididymal Lesion Removal)

Summary

The excision of a local lesion of the epididymis is a surgical procedure to remove abnormal growths, cysts, or nodules from the epididymis, a coiled tube located at the back of the testicle that stores and carries sperm.

Purpose

This procedure addresses conditions such as epididymal cysts or benign tumors that may cause pain, discomfort, or other symptoms. The goal is to eliminate these lesions to relieve symptoms and prevent potential complications such as infection or impaired fertility.

Indications

• Persistent pain or discomfort in the scrotal area.
• Presence of palpable lumps or nodules in the epididymis.
• Suspicion of benign or malignant growths.
• Recurrent infections or inflammation of the epididymis (epididymitis).
• Infertility or issues with sperm transport due to lesions.

Preparation

• Patients may be instructed to fast for a certain period prior to the procedure.
• A pre-operative assessment, including blood tests and imaging studies like an ultrasound, may be required.
• Medication adjustments, such as discontinuing blood thinners, could be necessary.

Procedure Description

1. The patient is administered local or general anesthesia to ensure comfort.
2. An incision is made in the scrotum to expose the epididymis.
3. The affected portion of the epididymis containing the lesion is carefully excised using surgical instruments.
4. Hemostasis is achieved to control any bleeding.
5. The incision is closed with sutures, and a dressing is applied.

Tools and equipment may include surgical scalpels, scissors, forceps, and sutures. The type of anesthesia used will depend on the patient's medical condition and the complexity of the procedure.

Duration

The procedure typically lasts between 30 minutes to an hour, depending on the complexity and location of the lesion.

Setting

The excision of a local lesion of the epididymis is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeons specialized in urology.
• Anesthesiologists or nurse anesthetists.
• Operating room nurses and surgical assistants.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Scarring or changes in the scrotal tissue.
• Potential damage to nearby structures affecting fertility.
• Anesthetic risks such as allergic reactions or respiratory issues.

Benefits

• Relief from pain and discomfort.
• Removal of potentially problematic or suspicious lesions.
• Prevention of complications such as infection or impaired sperm transport.
• Improved overall scrotal health and potential enhancement of fertility.

Recovery

• Post-procedure care includes keeping the incision site clean and dry.
• Over-the-counter or prescribed pain medications may be provided to manage discomfort.
• Patients are generally advised to avoid strenuous activities and heavy lifting for a few weeks.
• Follow-up appointments will be scheduled to monitor healing and remove sutures if necessary.

Alternatives

• Watchful waiting and regular monitoring if the lesion is small and asymptomatic.
• Needle aspiration or aspiration and sclerotherapy for cystic lesions.
• Ultrasound-guided needle biopsy for diagnostic purposes.

Each alternative has specific pros and cons, such as less invasiveness but potentially less definitive outcomes compared to surgical excision.

Patient Experience

During the procedure, patients under general anesthesia will not experience pain or discomfort. Those under local anesthesia may feel slight pressure or tugging but should not feel pain. Post-operatively, mild to moderate pain managed with medications is common. Most patients can return to normal activities within a few weeks, with full recovery expected in about 4-6 weeks depending on the individual healing process.