Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

Here, we present a protocol to treat patients diagnosed with an epididymal cyst using microscopic cyst resection. Based on microscopic manipulation, a largely improved visualization of the epididymis, subtle tissue structures was obtained, enabling accurate dissection and intact removal. To begin, examine the epididymal cord under 6x to 10x power magnification.

Using an electric knife, cut the epididymal capsule at the base of the epididymal cyst and normal epididymal tissue. Open the epididymal capsule carefully, and avoid opening the epididymal cyst cavity. After microseparating the epididymal cyst along the cyst wall, carefully isolate the epididymal tissue surrounding the base of the epididymal cyst.

Then microseparate the epididymal cyst from its base and the gap between it and the normal epididymal tissue. After occluding the epididymal tissue with a microvascular clamp or ligation with a 7 or 6-0 microsuture, excise the epididymal cyst from the base with microscissors or an electric knife. The represented data are derived from the 41 patients included in this study.

All epididymal cysts were completely removed within 30 to 50 minutes of the procedure. Bleeding during the operation was significantly reduced, and wound drainage was no longer required. The postoperative follow-up lasted for 3 to 50 months.

The surgical complications were assessed, and the data are shown here. No patient had a recurrence of the epididymal cyst, and no patient developed a postoperative scrotal hematoma. Only one patient had scrotal surgical site pain.

According to the follow-up data, microscopic treatment significantly reduced the incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain, thereby promising a higher surgical success rate and recurrence prevention. When performing this procedure, carefully dissect the separation, avoid epididymal cyst wall breakage, especially on blood epididymal cysts or large epididymal cysts with clear cystic fluid inside.