When an appendage is removed
Chronic epididymitis with induration, nagging pain and repeated exacerbations, tuberculosis of the appendage, sclerosed appendage after injury or unsuccessful operations - conditions in which removal of the appendage relieves pain in 80–90% of cases. Through an incision in the scrotum, the epididymis is separated from the testicle along its entire length with ligation of the vas deferens and vessels; the testicle returns to the scrotum. The wound is sutured with absorbable threads. On this side, sperm stop coming out; the second testicle ensures fertility.
Indications
- epididymal cyst (spermatocele) more than 1.5–2 cm, painful or growing;
- chronic epididymitis with pain that cannot be treated;
- tuberculous epididymitis, post-traumatic changes in the appendage;
- abscess of the appendage after purulent epididymitis;
- pain after a vasectomy (post-vasectomy syndrome).
Effect on fertility
The epididymis is part of the sperm's path from the testicle. Removing one epididymis stops sperm from coming out of that side, but the second testicle ensures fertility. Microsurgical excision of the cyst, on the contrary, preserves the patency of the ducts - this is important for young men planning children, and makes the operation preferable to sclerotherapy of the cyst.
