Review literature: (Rubenstein et al, 2004).
Spermatoceles are cysts of the epididymis, which arise from the epididymal duct and contain sperm.
The prevalence in ultrasound screening studies is 10%. The prevalence of spermatoceles increases with age (up to 30%).
Ultrasound imaging is very useful for differential diagnosis of scrotal swelling. Spermatoceles present with an anechoic cystic mass, in contact with the epididymis.
Disturbing size or pain.
Patients with unfulfilled child wish: Spermatocelectomy causes (with a high probability) sterility on the operated side. Delayed repair or cryopreservation of sperm is recommended, if fertility is an issue.
The testis is delivered through a scrotal incision. Resection of the spermatocele is done with careful dissection between spermatocele and epididymis. The ligation of final attachments of the spermatocele prevents granuloma formation. The operation is finished with the closure of the tunica vaginalis, tunica dartos (subcutaneous suture) and scrotal skin.
Sclerotherapy of spermatoceles is not a standard therapy and has been tested only in small studies.
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Dr. med. Dirk Manski (E-Mail)