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Journal of Visualized Experiments : JoVE Mar 2023Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative asoedema,...
Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative asoedema, hematoma, sustaining pain, and seminal tract obstruction in patients who have undertaken nonmicroscopic epididymal cyst resection or epididymal resection. Nonmicroscopic epididymal cyst surgery is suggested for patients with childbirth plans as a precaution. The treatment of male epididymal cysts via microtechnology is obviously a beneficial option; we took the lead in carrying out microscopic epididymal exploration and cyst resection surgery in China. From September 2017 to April 2021, 41 young and middle-aged male patients diagnosed with epididymal cysts underwent microtechnology treatment in a program titled "microscopic epididymal exploration and cystectomy". The postoperative follow-up lasted for 3-50 months. The results confirmed that, as microscopic manipulation largely improved visualization of the subtle tissue structures of the epididymis, the cyst could be clearly dissected apart and completely removed intact under the microscope. Bleeding during the operation was significantly reduced (2-3 mL) and wound drainage was not required. According to follow-up data, microscopic treatment significantly reduced the incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain, thereby promising a higher surgical success rate as well as recurrence prevention. Besides, preliminary experience and reflection suggest that microscopic epididymal exploration and cystectomy provide efficient preservation of the epididymal patency through refined treatment, while a better prognosis can be achieved. We recommend that surgery be carried out before the epididymal cyst develops to 0.8 cm in diameter, for fear that a larger epididymal cyst (>0.9 cm in diameter) could cause the complete destruction of all tubules of the ipsilateral epididymis - a more severe case with damage to the testicular output network.
Topics: Middle Aged; Humans; Male; Young Adult; Adult; Spermatocele; Epididymis; Testis; Cysts; Pain, Postoperative
PubMed: 37067264
DOI: 10.3791/64083 -
Canadian Urological Association Journal... Feb 2024Chronic epididymitis imposes significant physical and psychosocial distress on affected patients. Despite being a commonly encountered urologic condition, there remains...
INTRODUCTION
Chronic epididymitis imposes significant physical and psychosocial distress on affected patients. Despite being a commonly encountered urologic condition, there remains a paucity of understanding and literature surrounding the management and natural history of isolated epididymal pain. Typically, patients who do not respond to conservative management undergo an epididymectomy.; however, the literature on its efficacy is also scarce, with success rates varying widely from 10-90% in existing studies. Our goal was to better describe the etiology, and natural history of isolated epididymal pain. Furthermore, we aimed to describe the rates of success associated with epididymectomy.
METHODS
A retrospective case-control study was conducted at the Manitoba Men's Health Clinic, with the approval of the University of Manitoba Research Ethics Board. All patients presenting with chronic epididymitis, defined as discomfort or pain localized to the epididymis for at least three months, were identified. Information regarding patient demographics, past medical and surgical history, duration of pain, localization of pain, findings on previous ultrasounds, prior conservative therapies trialed and response rates, as well as response rates to surgical therapy were collected.
RESULTS
From April 2022 to 2023, a total of 275 patients with chronic orchialgia were identified, and among them, 74 patients specifically presented with chronic isolated epididymal pain. The average duration of symptoms was as follows: 22.9% of patients experienced symptoms for 3-6 months, 10% for 6-12 months, and 67.1% for over 12 months; 13.5% (n=10) had associated ejaculatory pain, 8.1% (n=6) had lower urinary tract symptoms, and 4.1% (n=3) had erectile dysfunction. Ultrasound findings were observed in 68.9% of patients, with 31.1% having an epididymal cyst, 27.1% having a varicocele, 5.4% having a spermatocele, and 4.1% having a hydrocele. Among those who underwent conservative therapy, only 36.2% of patients reported a positive response. Surgical intervention was performed on 23 patients, including 16 who underwent an epididymectomy, three who underwent cord denervation, and two who underwent vasovasostomy and spermatocelectomy each. Most (81.3%, n=13) patients who underwent an epididymectomy had a positive response to the surgical intervention, defined as no pain on followup, while all patients undergoing other surgical interventions experienced a positive response.
CONCLUSIONS
Chronic epididymal pain is a condition with limited data surrounding its management. Prior to referral, a large proportion of patients did not undergo any conservative treatment, and of those that did, there was limited response. For those who underwent surgical intervention, all were pain-free on followup, except three patients who underwent epididymectomy.
PubMed: 38381926
DOI: 10.5489/cuaj.8701 -
ANZ Journal of Surgery Jan 2020To evaluate the efficacy of aspiration and sclerotherapy with 100% alcohol for the primary treatment of benign scrotal cysts.
OBJECTIVE
To evaluate the efficacy of aspiration and sclerotherapy with 100% alcohol for the primary treatment of benign scrotal cysts.
METHODS
From March 2014 to March 2018, 114 patients were identified who underwent their first aspiration and sclerotherapy procedure (80 hydroceles and 34 spermatoceles/epididymal cysts). The procedure was carried out in the outpatient clinic with local anaesthesia. A 16-gauge IV catheter is used to puncture the sac under aseptic conditions. The volume of alcohol instilled was 10% of the aspirated volume (maximum of 50 mL). Patients were then observed in the waiting room and completed a questionnaire. Urology clinic follow up was scheduled at 6 weeks.
RESULTS
At follow up, 54 patients (67.5%) with hydroceles and 25 patients (73.5%) with spermatoceles/epididymal cysts had resolution after a single procedure. A second procedure was offered if fluid collection persisted, of which 71% of patients with hydroceles and 100% of patients with spermatoceles/epididymal cysts had a successful outcome. At a median of 31 months post-initial procedure, the overall success rate, after at most two procedures, was 80% for hydroceles and 85% for spermatoceles/epididymal cysts. The complication rate was low (6%). Almost all patients were happy to undergo the procedure again, if needed. Persistence following aspiration and sclerotherapy were more likely to occur in younger patients (45.4 versus 61.2 years, P = 0.001). Persistence was not related to the volume of fluid aspirated.
CONCLUSION
Aspiration and sclerotherapy with alcohol is a reliable, safe and effective technique for treatment of benign scrotal cysts.
Topics: Adult; Cysts; Epididymis; Ethanol; Humans; Male; Middle Aged; Patient Satisfaction; Retreatment; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Suction; Testicular Diseases; Testicular Hydrocele
PubMed: 31628703
DOI: 10.1111/ans.15467 -
Diagnostic Cytopathology Sep 2019
Review
Topics: Biopsy, Fine-Needle; Humans; Male; Middle Aged; Scrotum; Spermatocele; Spermatocytes
PubMed: 31041857
DOI: 10.1002/dc.24205 -
Folia Medica Cracoviensia Dec 2023Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15....
Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15. Obstruction in the epididymal efferent ductules with subsequent prostenotic dilatation of them, as well as dysgenesis due to hormonal disorders during fetal or postnatal life, are possible. At the 1st Department of Pediatric Surgery of A.U.Th. we treated 11 cases of boys at the age of 11-16 who presented with acute scrotum because of an epididymal cyst. The diagnosis was confirmed by ultrasound scanning . Due to persistent symptomatology, patients underwent surgical exploration and removal of the cyst. The postoperative care of the patients was uncomplicated with immediate remission of symptoms. In one case, ipsilateral acute epididymitis occurred after 10 days, which was successfully treated with antibiotic therapy. It is reported that approximately 50% of epididymal cysts involute within an average of 17 months. In conclusion, using the data obtained from the review, of the small in number of international bibliography studies, it is proposed conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision [1] of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24-48 months, cysts, regardless of their diameter, responsible for persistent symptoms and in the manifestation of acute scrotal symptoms due to inflammation, intravesical bleeding or secondarily torsion of the epididymis.
Topics: Male; Child; Adolescent; Humans; Adult; Spermatocele; Epididymis; Cysts; Scrotum; Ultrasonography
PubMed: 38578344
DOI: 10.24425/fmc.2023.148757 -
Urology Case Reports Nov 2020Ketamine related urinary tract complications were first reported in Hong Kong since 2007. The current case report describes a 37 years old male with long history of...
Ketamine related urinary tract complications were first reported in Hong Kong since 2007. The current case report describes a 37 years old male with long history of ketamine abuse, renal impairment, hypertension and HCV hepatitis, presented to us with insidious onset of painful scrotal swelling post bilateral nephrectomy, prostate and seminal vesicle preserving cystectomy. Radiological imaging and intraoperative finding revealed that it was a large spermatocele with urethroscrotal fistula, which was likely due to urethra stricture. The review of literature showed no guidelines for treatment, a symptoms based and multidisciplinary team approach is recommended.
PubMed: 32514403
DOI: 10.1016/j.eucr.2020.101284 -
Annals of Medicine and Surgery (2012) Jul 2022Gastric cancer (GC) is the fifth most common cancer and the fourth leading cause of death. It is much more common in advanced age and it is rare among the youngest...
INTRODUCTION
Gastric cancer (GC) is the fifth most common cancer and the fourth leading cause of death. It is much more common in advanced age and it is rare among the youngest patients (under 45 years of age).
CASE PRESENTATION
we report an unusual presentation of advanced gastric adenocarcinoma in 39-year-old man, who presented to our hospital with inguinal hernia without obvious gastrointestinal symptoms. He had strong family history of cancer, heavy smoking habit and weight loss. The intra-operative procedure identified a cyanotic separate spermatocele which was confirmed by the urologist. During investigation we found multiple liver metastasis in abdominal CT and advanced gastric adenocarcinoma from gastric biopsy and metastasis in spermatic cord sample and peritoneum sample of poorly differentiated adenocarcinoma.
CONCLUSION
Although stomach adenocarcinoma is extremely rare in young patient but it should be kept in mind of physicians as a possible diagnosis if there are many risk factors.
PubMed: 35860116
DOI: 10.1016/j.amsu.2022.103974 -
Urologie (Heidelberg, Germany) Oct 2022The systemic mast cell disease (MCAD; prevalence 17%) may occur frequently in urological patients. MCAD-induced changes include cysts in all organs, also in the...
The systemic mast cell disease (MCAD; prevalence 17%) may occur frequently in urological patients. MCAD-induced changes include cysts in all organs, also in the urogenital system. In the presence of MCAD, the surgical removal of such cysts must consider specific features of the MCAD in order to reduce surgical and complication risks. Vice versa, if in urological examinations multiple cysts are found, this could be an indication of a possibly existing, in some circumstances, unrecognized MCAD.
Topics: Cysts; Humans; Mast Cell Activation Disorders; Mastocytosis, Systemic; Prevalence; Urology
PubMed: 35508639
DOI: 10.1007/s00120-022-01841-4 -
Veterinary Clinical Pathology Mar 2020
Topics: Animals; Ascitic Fluid; Dog Diseases; Dogs; Epididymis; Inflammation; Lethargy; Male; Photomicrography; Spermatocele; Spermatozoa; Testis; Ultrasonography; Vasectomy
PubMed: 31927771
DOI: 10.1111/vcp.12815 -
Der Urologe. Ausg. A Mar 2022Mesotheliomas are very aggressive tumors, almost exclusively caused by asbestos. Four of the 5 mesotheliomas assessed in the years 2014-2020 were recognized as...
Mesotheliomas are very aggressive tumors, almost exclusively caused by asbestos. Four of the 5 mesotheliomas assessed in the years 2014-2020 were recognized as occupational diseases, the 5th case was discontinued due to lack of the patient's cooperation. Surgical exposure of the testis was performed under the suspected diagnoses of hydrocele (n = 3), spermatocele (n = 1) as well as "unknown" (n = 1). This proves that a histopathological examination of removed tissue is the gold standard in scrotal interventions. Every mesothelioma must always be reported as an occupational disease.
Topics: Humans; Male; Mesothelioma; Mesothelioma, Malignant; Testicular Hydrocele; Testicular Neoplasms
PubMed: 34652478
DOI: 10.1007/s00120-021-01689-0