Epidiymectomy

Overview

Removal of a portion of the epididymis. The epididymis is a coiled tube that collects sperm from the testicle and passes it on to the vas deferens.

Indications

When the epididymis becomes inflamed, it is called epididymitis. There are 2 types of epididymitis, chronic and acute. Acute epididymitis refers to a sudden onset and is usually treated with antibiotics. Chronic epididymitis is a long-standing condition, usually of gradual onset. The primary therapy is with medications and treatment such as non-steroidal anti-inflammatory medications and heat packs to reduce the discomfort. If  this does not provide adequate relief your Dr. may suggest this procedure. Most cases of epididymitis occur in adults.

Procedure

This procedure is done under a general anesthetic. An incision is made in the scrotum and the inflamed area is located and removed. Once that area is removed, the epididymis is no longer able to transport sperm on that side. However, if the other testicle is unaffected then most men are still able to father a child normally. In most cases, sutures will be used to close the scrotum. Those sutures will dissolve over the next 1 – 2 weeks as the skin heals. Local anesthetic is used around the operative site to minimize early discomfort. The local anesthetic will last 2 – 4- hours and oral pain medication is used from then on.

Post-Operative Instructions

Diet

You may return to your normal diet within 24 hours following your surgery. You may note some mild nausea and possibly vomiting the first 6-8 hours following surgery. This is usually due to the side effects of anesthesia, and will subside quite soon. We suggest clear liquids and a light meal the first evening following surgery.

Activity

Physical activity should be restricted the first 48 hours. During this time you should remain relatively inactive, moving about only when necessary. During the first few days following surgery you should avoid lifting heavy objects (anything greater than 15 pounds), and avoid strenuous exercise. If you are employed, ask us specifically about your restrictions for both home and work. We will write a note to your employer if needed.

You should plan to wear a tight pair of briefs or an athletic supporter for the first 4-5 days, even while sleeping. This will keep the scrotum immobilized to some degree and keep the swelling down. Ice packs should be placed over the scrotum the first 48 hours. Ice is a good pain reliever and keeps the swelling down. Fifteen minutes on and 15 minutes off is a reasonable schedule. Frozen peas or corn in a Ziploc® bag can be frozen, used, and refrozen.

Wound Care

In most cases, your incision will have absorbable sutures that dissolve within the first 10-20 days. Some may fall out even earlier. Expect some redness as the sutures dissolve, but this should occur only around the sutures. If there is generalized redness, especially with increasing pain or swelling, let your doctor’s medical assistant know. The scrotum will very likely get black and blue as blood spreads in the tissues. Sometimes the entire scrotum will turn colors. Black and blue is followed by a yellow and brown color. In time, this coloration will go away.

Hygiene

You may shower 48 hours after surgery. Tub bathing should be restricted until the seventh day.

If the pain is not too bad, you may take Tylenol (acetaminophen) or Advil (ibuprofen), which contain no narcotic agents and might be tolerated a little better with fewer side effects. If the pain medication you are sent home with does not control the pain, please contact your doctor.

Problems you should report to your urologist:

• Fever over 100.5 degrees Fahrenheit
• Moderate or fever swelling
• Drug reaction such as hives, rash, and nausea or vomiting