Spermatocele: Cyst of the Epididymis
Review literature: (Rubenstein et al, 2004).
Spermatoceles are cysts of the epididymis, which arise from the epididymal duct and contain sperm.
Epidemiology of Spermatoceles
The prevalence in ultrasound screening studies is 10%. The prevalence of spermatoceles increases with age (up to 30%).
Signs and Symptoms
- Painless testicular swelling
- Positive transillumination
- Seldom: disturbing size or pain
Diagnosis of Spermatoceles
Ultrasound imaging is very useful for differential diagnosis of scrotal swelling. Spermatoceles present with an anechoic cystic mass, in contact with the epididymis.
Treatment of Spermatoceles
Indication for surgery:
Disturbing size or pain.
Contraindication for surgery:
Patients with unfulfilled desire for a child: Spermatocelectomy causes (with a high probability) sterility on the operated side. Delayed repair or cryopreservation of sperm is recommended, if fertility is an issue.
Surgical technique of spermatocelectomy
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. Please see section spermatocelectomy.
Puncture of the Spermatocele with Sclerotherapy
Sclerotherapy of spermatoceles is not a standard therapy and has been tested only in small studies.
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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Rubenstein u.a. 2004 RUBENSTEIN, R. A. ;
DOGRA, V. S. ; SEFTEL, A. D. ; RESNICK, M. I.:
- Benign intrascrotal lesions.
In: J Urol
171 (2004), Nr. 5, S. 1765–72