Why under a microscope?
Epididymal cysts lie among the thinnest convoluted ducts through which sperm pass; without enlargement, they are easily damaged, which leads to obstruction and decreased fertility on this side. Under an operating microscope or magnifying glasses, the surgeon isolates the cyst from the ducts and removes it entirely without opening it - this eliminates relapse, which is typical for punctures and sclerotherapy. The incision on the scrotum is 2–3 cm, the sutures are absorbable, the swelling goes away within a week. The method is recommended for young men planning children.
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.
