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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

References

  Deutsche Version: Operative Therapie der Spermatozele