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When a spermatocele is first discovered, the cyst is about the size of a pea.

Postoperative management includes follow-up examinations. If received a vasectomy, then two semen samples must be collected and analyzed after 6-12 weeks post-operation and several ejaculations. The centrifuged semen samples are used to look for the absence of viable sperm in the semen.

The primary care physician may diagnose and manage benign causes of scrotal masses such as hydrocele, varicocele and spermatocele. However, if a "must not miss" diagnoses related to testicular masses such as testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer is suspected, the family physician must refer to a urologist.

Post-operative care includes pressure dressing, which consists of athletic supporter and gauze, ice packs are used to reduces swellin CHRONIC EPIDIDYMITISChronic epididymitis may be infectious or noninfectious in origin.

●Chronic infectious epididymitis is a rare, chronic infectious epididymitis. Some signs and symptoms include localized tenderness and swelling in the epididymis, which are different from any tenderness/abnormality present in the testis, these are usually not found in lower urinary tract. Chronic infectious epididymitis may be diagnosed in healthy adolescents as well as men. Some factors that predispose individuals to chronic infectious epididymitis include sexual activity, heavy physical exertion, and bicycle or motorcycle riding. Those diagnosed with chronic or recurrent epididymitis should receive a CT scan with contrast and a prostate ultrasonography to rule out structural abnormality of the urinary tract. If suspected to have chronic infectious epididymitis, consider getting a urinalysis, urine culture, and urine nucleic acid amplification tests for presence of Neisseria gonorrhoeae and Chlamydia trachomatis. Management of chronic infectious epididymitis is similar to management of acute infectious epididymitis, rarely does treatment extend to surgical management.

●Chronic noninfectious epididymitis – Trauma, autoimmune disease, or vasculitis can cause chronic noninfectious epididymitis, but no clear etiology is found in most cases. Idiopathic noninfectious epididymitis might be caused by the reflux of urine through the ejaculatory ducts and vas deferens into the epididymis, producing inflammation that leads to swelling and ductal obstruction. Unfortunately, men with history of vasectomy are also predisposed to chronic nonifectious epididymitis. Typical inciting factors include prolonged periods of sitting (long plane or car travel, sedentary desk jobs) or vigorous exercise (heavy lifting). Acute infectious epididymitis are often associated with more tenderness and swelling, whereas chronic noninfectious epididymitis tend to have less tenderness and swelling upon examination. Thorough past medical history and physical examination can help with determining the diagnosis. It is often that individuals with chronic noninfectious epididymitis will present with a history of a lack of symptom improvement while on antibiotic therapy. Management of chronic noninfectious epididymitis includes scrotal elevation, nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (unless unable to take for medical reasons), and it is recommended that individuals avoid physical activities that may cause said symptoms. Those with sedentary jobs or often experience prolonged periods of time sitting should practive more physical mobility frequently.

Pre-operative preparation for a spermatocelectomy

Individual preparing for a spermatocelectomy should sit in the supine position. Some general, spinal or local anesthesia is required before starting the surgery. If individuals preparing for spermatocelectomy have risk factors for wound infection, perioperative antibiotic prophylaxis or can be given as prevention for pissible infections.

Spermatocelectomy surgical technique

Spermatocelectomy surgical technique is as followed: Start the surgical approach to the testis by a scrotal incision.


 * Incision of the visceral tunica vaginalis covering the spermatocele.
 * Dissection of the spermatocele without damaging surrounding epididymal tissue.
 * The basis of the spermatocele is ligated, the visceral tunica vaginalis is closed with a running suture (Vicryl 5-0).
 * Closure of the parietal tunica vaginalis with a running suture (Vicryl 3-0). Readaption of the subcutis (Tunica dartos). Skin closure.