Excision Of Epididymal Cyst

What Is An Epididymal Cyst?

A cyst is a collection of fluid enclosed in a membranous tissue. An epididymal cyst is attached to the epididymis, which is located adjacent to the testis. It occurs due to a blockage of one of the many fine tubes that form part of the epididymis.

What Are The Indications For Excision Of Epididymal Cyst?

Possible reasons for excision of epididymal cyst include:

  • Pain in scrotum
  • Epididymal cyst interfering with daily activities
  • Increasing size of cyst

What Does Excision Of Epididymal Cyst Involve?

Dr Vasudevan performs excision of epididymal cyst as a day procedure under a general anesthetic in a hospital. You will be asked to fast for 6 hours before the surgery. Once you come to the hospital you will be admitted by the nursing staff. Once admitted you will be taken to the operating room when it is your turn to be operated on.

The anesthetist will give you the medications to make you to go to sleep completely. Once you are asleep the surgery will commence.

An incision will be made in the middle of your scrotum. The testicle with the epididymal cyst is exposed. The cyst is dissected intact and completely excised from the epididymis. In some cases a portion of the epididymis may need to be excised with the cyst. Any blood vessels that are open are sealed to prevent bleeding. Once completed the testicle is placed back into the scrotum. The scrotum muscle and then the scrotal skin is then closed with dissolving stiches. Local anesthetic is infiltrated around the wound to provide pain relief.

Once the operation is completed, you will be woken up by the anesthetist and sent to the recovery unit, for observation.

Once you have fully recovered and woken up, you will be discharged from hospital on the same day.

As the surgery is done under a general anaesthetic you will not be able to drive home yourself and hence a friend or family member will need to take you back home.

Recovery After Excision Of Epididymal Cyst

It is common to experience the following after an excision of epididymal cyst:

  • Scrotal pain – this is normal and is usually present for a week or so. Simple pain killers such as paracetamol or anti-inflammatories may be needed to help with pain relief.
  • Swelling of scrotum – this is normal and will take about a week or so to subside
  • Bruised appearance of scrotum – will resolve in a week or so.

While normal gentle daily activities can be performed, it is advisable not to perform excessive physical activity for about 2 weeks after surgery.

Also wearing underwear which provides good support for your scrotum is recommended.

Complications After Excision Of Epididymal Cyst

Possible complications from an excision of epididymal cyst include:

  • Hematoma – despite sealing blood vessels during the operation it is possible to have a bleed within the scrotal sac after the surgery (hematoma). If this happens it will cause a firm swelling to the scrotum, which will also be painful. Normally there is no need to perform surgery to remove the hematoma. The body will reabsorb the hematoma by itself, but will take 4 to 6 weeks to do so, depending on the size of the hematoma.
  • Wound infection – the scrotum will appear swollen and red. Antibiotics will need be needed to treat this.
  • Wound dehiscence – This is when the stiches on the scrotal incision start to come loose and hence the wound comes apart. Either a small part or a larger part of the wound may come apart. Either way there is no need to restitch the wound. The body will heal and will close the wound by itself. It will take 4 to 6 weeks for this to take place depending on the size of dehiscence.
  • Reduced fertility – If a part of the epididymis has been removed along with the cyst, then then amount and the quality of sperm will be reduced and compromised. As a result, it is not advisable to have an excision of epididymal cyst in men who want more children and have not yet completed their family.
  • Damage to testis – damage to the testis during correction of the hydrocele procedure is extremely rare. If such an injury were to occur, it can be rectified in most cases. If an irreversible injury occurs then then the testis may need to be completely removed.

Follow-Up With Dr Vasudevan

Dr Vasudevan will have a follow-up appointment with you 8 weeks after the completion of surgery. He will review the wound and assess if complete healing has occurred.