Name of the Procedure:

Epididymectomy; unilateral
(Epididymal surgery, Testicular duct removal)

Summary

An epididymectomy is a surgical procedure to remove one side of the epididymis, a tube at the back of the testicle that stores and carries sperm.

Purpose

• Medical Condition or Problem: Chronic epididymitis, spermatocele, or obstruction
• Goals: To relieve persistent pain, prevent recurrent infections, or alleviate blockages hindering sperm passage.

Indications

• Persistent or recurrent epididymitis unresponsive to medical therapy
• Large or symptomatic spermatocele
• Obstruction causing pain or fertility issues
• Other conditions causing chronic scrotal pain

Preparation

• Pre-Procedure Instructions: Follow fasting guidelines, typically no food or drink for at least 8 hours before the procedure.
• Medication Adjustments: May need to stop certain medications like blood thinners.
• Diagnostic Tests: Ultrasound of the scrotum, blood work, and any other relevant imaging tests.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made in the scrotum.
3. Isolation of Epididymis: The surgeon carefully isolates the epididymis from the testicle.
4. Removal: The affected epididymis is removed surgically.
5. Closure: The incision is closed with sutures.
6. Dressing: Wound dressing is applied to prevent infection.

Duration

Typically, the procedure takes about 30 minutes to 1 hour.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Urologist or specialized surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Common Risks: Infection, bleeding, and scrotal swelling.
• Rare Risks: Chronic pain, reduced fertility, and formation of hematomas.
• Management: Antibiotics for infections, pain management, and follow-up for complications.

Benefits

• Relief from chronic pain and recurrent infections
• Resolution of symptoms associated with spermatoceles
• Improvement in overall quality of life
• Benefits typically noticed within a few days to weeks post-surgery

Recovery

• Post-Procedure Care: Rest, application of ice packs, and wearing tight-fitting underwear or athletic supporter to reduce swelling.
• Recovery Time: Most patients recover within 1 to 2 weeks.
• Restrictions: Avoid heavy lifting, strenuous activities, and sexual activities until cleared by the doctor.
• Follow-Up: Appointments to monitor healing and address any complications.

Alternatives

• Conservative Management: Antibiotics for infections, pain management with medications.
• Aspiration or Sclerotherapy: Treatment of spermatoceles without surgery.
• Pros and Cons: Non-surgical options may provide temporary relief or be less effective, while surgical intervention offers a more definitive solution but involves surgical risks.

Patient Experience

• During Procedure: Patient will be under anesthesia, so there will be no pain or awareness during the procedure.
• After Procedure: Mild to moderate pain managed with prescribed painkillers, possible swelling, and discomfort, which generally subside within a few days.
• Pain Management: Ice packs and medications as prescribed to manage pain and swelling.