You are here: Urology Textbook > Surgery (procedures) > Spermatocelectomy

Spermatocelectomy: Surgery for Spermatoceles

Indication for a Spermatocelectomy

Symptomatic spermatoceles: disturbing size or pain.

Contraindications to Spermatocelectomy

Elective indication: coagulation disorders, any disease with an increased risk for surgery. Surgery of the epididymis usually leads to closure of the epididymal duct. Spermatocelectomy should be performed later, if fertility is an issue.

Preoperative Patient Preparation

• Patient positioning: supine position
• General, spinal or local anesthesia
• Perioperative antibiotic prophylaxis, if risk factors for wound infection are present

Spermatocelectomy: Surgical Technique

• Surgical approach to the testis by a scrotal incision.
• Incision of the visceral tunica vaginalis covering the spermatocele.
• Dissection of the spermatocele without damaging surrounding epididymal tissue.
• The basis of the spermatocele is ligated, the visceral tunica vaginalis is closed with a running suture (Vicryl 5-0).
• Closure of the parietal tunica vaginalis with a running suture (Vicryl 3-0). Readaption of the subcutis (Tunica dartos). Skin closure.

Complications of Spermatocelectomy

• Bleeding
• Infection
• Sperm granuloma
• Obstruction of the epididymal duct with infertility.
• Testicular loss due to complications is rarely possible.

References

  Deutsche Version: Operative Therapie der Spermatozele