The surgical removal of the eididymis is called Epididymectomy. This operation is rarely advised and is used only as a last option in the treatment of pain. It may be advised if the patient is having a chronic infection which does not respond to antibiotics, and for post-operative complications of a vasectomy procedure.

Epididymectomy is also indicated in conditions of inflammation or infection of the epididymis called epididymitis. An epididymal cyst is another condition in which fluid-filled swelling occurs in the epididymis, and is common in men above 40 years of age. If there are multiple such cysts, removal of the entire epididymis is done through an epididymectomy procedure.

Conditions requiring an Epididymectomy

An epididymectomy is recommended only when the pain is localized to the epididymis. Unilateral or bilateral epididymectomy is a more feasible treatment option in conditions such as chronic orchialgia related to post vasectomy pain syndrome or chronic epididymitis. Other conditions in which epididymectomy is indicated are listed below:

• Chronic scrotal pain
• Epididymal cysts
• Chronic epididymo-orchitis
• Complex epididymal cystic disease
• Abscess or chronic recurrent epididymitis
• Epididymal tuberculosis resulting in caseation and a firm expanding mass
• Post-vasectomy epididymal engorgement

How is an Epididymectomy procedure done?

Epididymectomy is performed using various techniques, which may be partial or total and unilateral or bilateral. The surgeon chooses the one most suitable for the patient’s condition.

Generally, Epididymectomy is performed under local anesthesia on an outpatient basis. The procedure is a testicle-sparing procedure and may take about an hour.

Most patients can return home on the day of the procedure, however, if it is done under general anesthesia, the patient may need to stay overnight at the hospital, following the procedure.

The doctor makes a transverse incision on the scrotal sac, just as big to allow the separation of the epididymis from the testicle and its surgical removal.

The testicle will be placed back into the scrotum, and then the incision is closed using sutures. A small drain may be placed at the incision site to drain out excess blood or fluid from the scrotum after Epididymectomy.

What are the risks and complications of Epididymectomy?

Epididymectomy is generally a safe procedure. Potential risks and complications exist as with any major surgical procedure, and these include:

• Collection of blood within the scrotal sac
• Infection
• Formation of blood clots in blood vessels
• Contraction of testicle

Which are the different tests that have to be performed before Epididymectomy?

Some of the different tests which have to be performed before Epididymectomy are:

1. Ultrasound
2. X-ray