Epididymectomy is a surgical procedure to remove the epididymis, which is an essential part of the male reproductive system. The epididymis is a structure located inside the scrotum, which is attached to the posterior side of the testis, and is connected with the vas deferens, which in turn is connected with the urethra. The epididymis is important in the storage, maturation and transport of sperm. An epididymectomy is usually indicated for the treatment of chronic epididymitis, or the long-term inflammation of the epididymis, and for men with complex epididymal cystic disease.
Symptoms of epididymitis include pain in either one or both sides of the scrotum, usually lasting three months or more. The pain in the scrotum generally interferes with the performance of daily life activities. Chronic epididymitis is usually associated with bacterial infections, obstruction of the vas deferens, abnormalities of the lower urinary tract at birth, or as an occurrence after a vasectomy, which is a surgical procedure done by cutting or binding the vas deferens. Broad-spectrum antibiotics are often given to patients with chronic epididymitis. The presence of pus or abscess in the scrotum, however, generally requires surgery to protect the testicles from further inflammation.
Medical doctors who specialize in the field of urology are commonly responsible for the diagnosis, treatment and management of disorders affecting the male reproductive system. These healthcare professionals also typically perform epididymectomy surgeries to relieve the symptoms of pain presented by patients with chronic epididymitis and other associated conditions. This surgery is often a last recourse after many conservative treatments, such as the use of antibiotics and analgesics, have been attempted.
There are many variations in technique, and the one a surgeon chooses frequently depends on the patient's condition. The medical procedure is generally done under local anesthesia. A transverse incision is usually made on the scrotal sac, just large enough for the urologist to see the vas deferens, testis and epididymis, and to allow the surgical removal of the epididymis and drainage of pus in the scrotum. After the procedure, patients are usually sent home with medications and general instructions on proper care.
Burning and presence of blood during urination may occur after surgery, but usually will resolve within three days. Other complications can include skin infection, chronic pain and infertility. Atrophy, or reduction in the size, of the testicles may also result if the spermatic cord is injured during the dissection process.