What is an Excision of Spermatocele?
Excision of spermatocele, also called “spermatocelectomy”, is the surgical removal of a spermatocele from your testicle (the male reproductive organ).
- Spermatocele: A fluid-filled pain free benign cyst
- Forms inside the scrotum, a pouch of skin containing the testicles
- Found near the top or behind the testicles
- Most often attached to the epididymis
- Epididymis: A long, coiled tube that rests on the backside of each testicle
- Stores sperm produced in the testicle
- Allows sperm to flow to the penis via the vas deferens
A spermatocele can form following another surgery called “vasectomy”.
Vasectomy (male sterilization) is performed to block the supply of sperm to the semen that is ejaculated from the penis. This procedure involves cutting and sealing off the “vas deferens”, the tube that carries the sperm from the epididymis to the penis.
When a man has a vasectomy, sperm continues to flow from the testicle but becomes backed up in the epididymis due to the cutting and sealing off of the vas deferens. An obstruction in the epididymis might be a potential cause of spermatocele post vasectomy.
Indications for Surgery
A spermatocele, also known as a spermatic cyst, is generally pain-free and benign (noncancerous). It is known to resolve on its own without causing any symptoms. Therefore, most men with a spermatocele require little or no treatment.
However, if the cyst grows too large it may cause:
- Discomfort or pain in the affected testicle
- Heaviness or a feeling of fullness in the testicle
- A swollen or enlarged scrotum in severe cases
This may necessitate the surgical excision of the spermatocele.
Preparing for Surgery
Prior to the surgery, you will need to:
- Tell your surgeon about the medicines you are taking
- Arrange someone to drive you home after the surgery
- Avoid eating or drinking anything after midnight on the day of surgery
The excision of a spermatocele is mostly done on an outpatient basis using local or general anesthesia, meaning no overnight stay in the hospital.
During the surgery:
- A small incision is made in the scrotal wall right over the spermatocele.
- The membrane covering the testicle and the spermatocele is opened.
- The testicle with its spermatocele attached to the epididymis is lifted out.
- The spermatocele is carefully cut at its base and separated from the testicles.
- The base of the cyst is secured with sutures to prevent spermatocele recurrence.
- The incision in the scrotum is closed with dissolvable stitches and a dressing is applied.
The surgery may take less than an hour to complete.
Immediately After the Surgery
You will be taken to a room where you will be monitored closely for any problems. You will be cleared to go home once the surgeon feels you are fine.
Care at Home
Once you are at home after the surgery, you need to:
- Take pain medications as prescribed
- Protect the incision site with a gauze-filled scrotal support
- Apply ice packs for about a week to keep swelling down
- Make regular visits to the surgeon for follow-up exams
- Take a minimum of 10 to 14 days off from the work
- Avoid heavy lifting or strenuous exercise for 1or 2 weeks
Risks or Complications
- Damage to epididymis or vas deferens
- Swelling & bruising of the scrotum
- Bleeding or infection in the scrotum
- Blood clotting inside the scrotum
- Sperm leakage into the scrotum
- Chronic pain in the testicle or scrotum
- Blood collection or infection around the testicle
- Pus collection and abscess formation
- Impaired fertility or infertility
- Recurrence of spermatocele (rare)
When to Consult the Surgeon
Contact your surgeon immediately if you experience fever, bleeding, or increased pain during post-surgery care at home.