Cyst of the epididymis( epidemo) - Causes, symptoms and treatment. MF.

Epididymocele or cyst of the epididymis is a benign cavity neoplasm that originates from the epididymis of the testicle. The disease occurs at any age, but most often it affects men older than 25 years who have an active sexual life. Due to the meager clinical symptomatology, the cyst of the epididymis is often an accidental diagnostic or sectional finding.

Cyst of epididymis

Causes of cyst appendage of testicle

Among the etiological factors cysts of the epididymis must be isolated congenital and acquired. Congenital belongs to retention, which means a violation in organogenesis, as a result of which a cavity is formed between the tissues of the appendage, which is then filled with a transparent transudate.

In contrast to congenital retention, which is rare, more frequent cysts of the epididymis should be considered a scrotal injury or an inflammatory disease of the urogenital organs in men. The most important for the development of epididymo is the inflammation of the epididymis, the result of which is a violation of the morphological structure of this organ, which may serve as the reason for the development of the cyst. Therefore, if a patient has a history of inflammatory diseases of the scrotal organs, he must periodically undergo preventive examinations from the urologist.

Symptoms of the cyst of the epididymis

As a rule, the epididymo has no clinical symptoms. In most cases, it is discovered absolutely accidentally during bathing or medical examination. There is a disease in the form of a small rounded soft formation near the upper pole of the testicle, painless on palpation.

A brighter clinical picture is observed when the epididymis is torn or twisted. Then the patient is disturbed by severe pains in one of the half of the scrotum, where a dense painful formation is palpated, over which, as a rule, hyperemic skin is visualized. Over time, clinical symptoms increase, and palpation of the formation becomes impossible due to severe swelling of the scrotum.

In order to avoid such a situation, in the presence of similar education it is necessary to immediately seek help from a urologist who can correctly diagnose and select the treatment tactics.

Diagnosis of the cyst of the epididymis

As a rule, the clinical picture is enough to accurately diagnose epididymo. Only to determine the tactics of treatment, it is necessary to make another study, namely, scrotal ultrasound. The purpose of this method is to determine the exact position of the cyst of the epididymis, as well as determine the size of the latter.

In some cases, a puncture is performed for differential diagnosis of the epididymis of the testicle with a malignant neoplasm. Under the control of ultrasound, a cyst is punctured and a liquid or soft tissue is taken for analysis. As a result of the histological examination of the puncture material, an accurate diagnosis can be made.

Treatment of cysts of the epididymis

The main and, in principle, the only effective method of treatment of cysts of the epididymis can be considered only surgical intervention. As a rule, it is performed under local anesthesia, since the amount of such an operation is minimal. After treatment of the operating field with iodine and alcohol in aseptic conditions, a cut of the skin over the pathological neoplasm is performed. During the revision of the scrotum cavity, there is a cyst of the epididymis and a soft clamp is pinched at the base. Next, the pathological neoplasm is cut off by the scalpel and sent for histological examination. Under the remaining clamp the thread is stretched and the vessels are tied up, which can supply blood to the cyst. The cavity of the scrotum is dried with sterile napkins and layer-wise sutured. When the cyst ruptures, a drainage tube can be installed to evacuate the pathological contents of the scrotum.

Operation

In the postoperative period, antibiotics of a wide spectrum of action, such as ceftriaxone or ampicillin, are prescribed.

Features of diet and lifestyle

After surgery, patients for about two months are advised to refrain from physical exertion and wear elastic trunks. The first recommendation is given to prevent the divergence of the operating wound, and the second - to reduce edema of the scrotum and normal healing of the suture.

Rehabilitation after illness

In addition to the aforementioned elastic trunks for normal wound healing, it is necessary to carry out daily dressings with an antiseptic solution such as betadine in the first two weeks after the operation. This item requires special attention due to the fact that such operations are considered by some surgeons as outpatient and the patients go home on the same day. Often they disregard the recommendations of the doctor, because of what then have serious consequences. So, patients with a transplanted operation for epididymo-target for at least the first three days should be kept in the hospital.

If the postoperative wound is compromised initially, for example, by cyst rupture or purulent inflammation, it is recommended to use physiotherapeutic methods of treatment, such as UHF, in the postoperative period. However, it is not necessary to get carried away by the latter, as they raise the temperature in the scrotum, which affects the spermatogenesis negatively.

Treatment with folk remedies

Not so long ago folk healers believed that such diseases can be treated physically, using various massage techniques. After several similar procedures ended with ruptured cysts of the epididymis, they refused massage for this disease. Now, for the treatment of epididymo, the medicine men are offered various compresses and lotions, which, as it were, contribute to resorption of the neoplasm. The question of their effectiveness is controversial, but the question of their harm is not negotiable. Any compresses on this area, even the most harmless in terms of their composition, increase the temperature in the scrotum, which leads to a violation of the process of spermatogenesis and, as a consequence, leads to male infertility.

Thus, in the presence of such a neoplasm in the scrotum, it is better to immediately seek help from a qualified specialist, rather than transfer one pathology to another from folk healers.

Complications of the cyst, epididymis of the testicle

As already mentioned, the main complications of the epididymo is the cyst and torsion. Both the first and the second lead to inflammation in the cavity of the scrotum. With untimely treatment, this can threaten the development of a purulent process, which can result not only infertility, but also melting of the testicle, the treatment of which consists only in the removal of this organ.

Prevention of

This pathology is bad because there is no specific prevention from it. It is possible to name only fortifying procedures which promote increase of level of immunity and prevent inflammatory diseases. Also, those patients who have epididymoceles, but who refuse surgical treatment, it is necessary to refrain from active sports activities in order not to damage the cyst.

Rev.doctor urologist Astashin Е.Е.