Epididymectomy in the management of intrascrotal disease:

Abstract

Objective To assess the outcome of epididymectomy as a method of treating epididymal pathology. Patients and methods Forty‐one patients who underwent epididymectomy between 1990 and 1995 were analysed retrospectively; their clinical records were reviewed and their satisfaction with the outcome and relief of symptoms assessed using a questionnaire and/or telephone interview. Results Twenty‐nine patients with pain were subdivided into three categories depending on the indication for epididymectomy, i.e. post‐vasectomy epididymal engorgement (eight patients), complex cystic disease (11) or ‘chronic epididymitis’ (10). The outcome was satisfactory in 27 of the 29 patients. The best results were obtained in the group who underwent epididymectomy after vasectomy, where seven of eight improved after the procedure. Those with chronic epididymitis had the least favourable outcome, with only seven reporting any improvement in symptoms. Conclusions Epididymectomy has a valuable role in the management of epididymal pathology in appropriately selected patients.

Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome

“…Siu et al 21 likewise claimed 100% patient satisfaction in 25 patients with PVPS undergoing epididymectomy. Furthermore, Sweeney et al 22 reported a satisfaction level of 87.5% with this technique, recording best overall outcomes in the PVPS group, while Chen and Ball 23 indicated that 5 of 10 patients with PVPS (50%) were pain-free after epididymectomy. In spite of these successes, epididymectomy with PVPS remains controversial.…”

Tubular ectasia of the epididymis: A sign of postvasectomy status

“…5 Although the etiology of scrotal pain or epididymalgia remains unclear, mechanical obstruction with perineural fibrosis and epididymal compression from adjacent cysts have been postulated as possible etiologic factors in scrotal pain after vasectomy. 4,6 Postvasectomy changes of the epididymis were pathologically characterized by long-standing obstruction of the epididymal tubules. Tartar et al 7 attributed these changes to the backup of sperm into the epididymis with distention of the tubules leading to cystic change.…”

Chronic epididymitis: is epididymectomy a valid surgical treatment?

“…The mechanism in those without a history of vasectomy may be the same but the changes are not as marked (Chen & Ball, 1991). The work of Chen & Ball (1991) and Sweeney et al. (1998) demonstrated that the histological appearances are not good predictors of clinical outcome and therefore these are not commented upon in this study.…”