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Spermatocelectomy: Surgery for Spermatoceles
Indication for a Spermatocelectomy
Symptomatic spermatoceles: disturbing size or pain.
Contraindications to Spermatocelectomy
Surgery of the epididymis usually leads to dissection of the epididymal duct. 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.
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 possible infertility
- Rare: loss of the testis due to bleeding or infection
Urologic Surgery | Index | Spermatocele |
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
References
Deutsche Version: Operative Therapie der Spermatozele