Scrotal cyst removal

Scrotal cyst is a fairly common disease. Surgical methods are used for treatment, that is, removal. Let's consider the types of operations and their features.

According to medical statistics, cystic formations of the scrotum are detected in 30% of patients who have undergone an ultrasound examination of this organ. Tumor lesions of the appendages of the testicles and spermatic cords do not have a pronounced clinical picture. It is the appearance of painful sensations that is the reason to contact a urologist-andrologist and undergo diagnostics.

According to the international classification of diseases ICD-10, scrotal cysts are included in category II Neoplasms (C00-D48):

D10-D36 Benign neoplasms.

• D29 Benign neoplasm of male genital organs.
  • D29.4 Neoplasms of scrotum and skin of scrotum.

Cystic lesions occur at any age. The following organ tumors are distinguished:

1. Epididymis cyst (spermatocele) – occurs due to a disruption in the outflow of secretions from the epididymis. The benign hollow formation has an oval shape and is located in a fibrous capsule that is not connected to the surrounding tissues.
2. Spermatic cord cyst (funiculocele) – formed by accumulation of serous secretion between the layers of the spermatic cord sheath. Manifested as a palpable spherical formation that is not fused with the testicle or appendage. Causes aching pain in the scrotum, which intensifies with physical activity.

Conservative therapy is ineffective, so patients are recommended surgery. Surgical intervention involves removing the cyst without damaging its membrane. Subsequently, the epididymis is sutured.

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Indications for the procedure

Scrotal cysts occur at any age, but most often in boys aged 7-14. This is due to puberty and the active formation of the genitals.

Main symptoms:

• Abnormal enlargement of the scrotum.
• Severe pain during physical activity.
• Swelling and redness of tissues.
• Increased body temperature.
• General weakness.

The tumor is benign, but despite this, it requires surgical treatment. Indications for removal are painful sensations due to tissue proliferation. In some cases, the fluid in the fibrous formation is subject to infectious processes, causing inflammation and severe painful sensations.

The main reasons for removing a scrotal cyst are:

• The neoplasm slowly increases in size, but gradually stretches the tissues of the scrotum, causing a significant cosmetic defect.
• Trauma to the groin area can cause the cyst to rupture.
• Deformation of scrotal tissue.
• Development of a malignant process due to a sharp increase in the tumor and its compaction.
• Dysfunction of the sperm ducts.

Surgical intervention is indicated if the cyst is more than one centimeter in diameter. To determine its size, an ultrasound examination is performed, which allows one to clearly see the boundaries of the cyst.

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Preparation

Removal of a scrotal cyst requires special preparation. At the first stage, the patient undergoes a physical examination. The doctor examines and palpates the affected organ, collects anamnesis. At the next stage, instrumental methods are prescribed:

• Diaphanoscopy – using transillumination, the doctor evaluates the passage of light rays through the tissues of the scrotum. If there is a cyst with fluid, it glows pink.
• Ultrasound examination is necessary to determine the size and location of the tumor.
• MRI of the pelvic organs – it is used to obtain a layer-by-layer image of tissues, which allows for a more accurate determination of the nature of the tumor.

In some cases, a testicular biopsy with histology and blood tests for tumor markers are prescribed. Two weeks before surgery, patients are prescribed antibacterial drugs from the fluoroquinolone group.

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Technique scrotal cyst removal

Conservative therapy of scrotal cysts is ineffective. The main method of treatment is surgical intervention. There are many methods for removing such formations. Let's consider the main types of surgery and the features of the technique for performing surgery to remove a scrotal cyst.

1. Surgical removal

The procedure is performed under anesthesia (local, general). As soon as the anesthesia has taken effect, an incision is made on the surface of the cyst to enucleate the neoplasm. After cleaning the cystic cavity, the doctor performs layer-by-layer suturing of tissues with self-absorbable, cosmetic threads that do not leave scars. At the end of the operation, an aseptic bandage and a cold compress are applied.

2. Sclerotherapy

This method involves removing the neoplasm by introducing a chemical substance into the cystic cavity, which helps to glue its walls together. Using a syringe, the cyst is cleared of serous fluid and a medicinal product is introduced into the cavity. Due to this, the tissues lining the interior are destroyed (sclerosed).

This method is used if the man does not plan to have children in the future. This is due to the fact that the procedure can be complicated by the gluing of the spermatic cords.

3. Laparoscopy

The most effective and safe operation. The procedure is performed under general anesthesia. Using a laparoscope, which is equipped with a special camera and instruments, the doctor makes a small incision in the tissue. The cavity being operated on is filled with carbon dioxide, which creates the space necessary for the operation and stretches the tissue. During the procedure, the cystic sac with liquid contents is removed. The cavity is washed with disinfectant solutions.

Advantages of the method:

• Doesn't take much time.
• Has a minimal risk of developing complications
• The tumor does not recur.

After the operation, the patient spends a couple of days in the hospital under medical supervision. To prevent the development of edema, it is necessary to lie on your back. A special bandage is applied to the scrotum to immobilize it. Anti-inflammatory drugs and a diet are also prescribed to speed up recovery.

4. Puncture

This operation is similar in technique to sclerotherapy, but without the use of chemicals. The cyst is punctured with a needle and all its contents are removed with a syringe. After some time, the membrane is filled with liquid again. Repeated puncture can lead to damage to the appendage and testicle.

Of all the above methods, laparoscopy is the most common. This operation has minimal risks of damage to the testicle, its appendages or the vas deferens. The success of the removal depends on the professionalism of the urologist and his technique.

Contraindications to the procedure

Like any operation, surgical removal of a scrotal cyst has certain contraindications for implementation, let's consider them:

• Severe pathologies of the cardiovascular or respiratory system.
• Blood poisoning.
• Purulent peritonitis.
• Terminal states.
• Recent abdominal surgeries.
• Early childhood of the patient (high risk of complications after anesthesia).
• Extreme obesity.
• Blood clotting disorders.
• Severe hemodynamic disturbances.
• Infectious and inflammatory processes in the body.
• Malignant neoplasms.

Also taken into account is intolerance to chemicals used in sclerotherapy and medications used for anesthesia.

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Consequences after the procedure

The patient's postoperative behavior largely determines the risk of developing consequences after the cyst removal procedure. Surgical intervention can lead to the following problems:

• Formation of scars and tumors on the scrotum.
• Severe swelling.
• Bacterial wound infections.
• Hematomas.
• Increased sensitivity of the scrotum.
• Infertility (adhesion of spermatic cords during sclerotherapy).
• Recurrence of neoplasm.

To reduce the risk of developing the above-mentioned consequences, all doctor's orders should be followed. In the first days after the operation, complete rest and immobility are recommended. A support bandage is applied to the operated organ. To avoid swelling, the patient is recommended to rest on his back so that the organ is in an elevated position.

The patient must regularly apply compresses with ice or cold water. It is also contraindicated to remove the bandage from the wound on your own, have any sexual intercourse, hot baths and exercise. A special diet is prescribed to speed up recovery. Failure to follow postoperative recommendations may cause injury to the operated area. Because of this, the recovery process will be significantly delayed.

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Complications after the procedure

Despite the fact that surgical treatment of cystic neoplasm in the scrotum is not a complicated operation, there is a risk of developing postoperative complications:

• When an infection penetrates the scrotum, purulent-inflammatory processes begin. The organ increases in size, swells and turns red. Severe pain occurs when touching the tissues.
• If the operation is performed by a urologist with insufficient experience, there is a risk of mechanical damage to the spermatic cord. This leads to a rupture of the cyst capsule and the entry of its serous fluid into the scrotum. As a result, a severe inflammatory process develops.
• During sclerotherapy, there is a risk of gluing not only the cystic membrane, but also the spermatic cord, which leads to infertility. This complication is also possible with untimely treatment of the problem, when the neoplasm increases in size so much that it compresses the vas deferens, disrupting the passage of sperm and reproductive function.

Timely seeking of medical help and the right type of surgical treatment can help avoid the above complications.

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Care after the procedure

Treatment of scrotal cysts requires strict adherence to postoperative rules. Post-procedure care consists of:

• Bed rest for 3 days with cold compresses (reduce swelling and reduce pain).
• Wearing compression garments/bandages to ensure that the testicles are in the anatomically correct position.
• Avoid any physical activity until the stitches have completely dissolved.
• Taking medications prescribed by a doctor (antibiotics, anti-inflammatory drugs, painkillers).

Nutrition and supplying the body with useful substances are of great importance in the recovery process. Vitamin complexes are recommended to enhance the immune system's protective properties. As for the diet, it is aimed at restoring the reproductive system and consists of the following recommendations:

• Overeating is prohibited. You need to eat small portions throughout the day. There should be about five small meals per day.
• The food should be as gentle as possible, not fatty, not salty or peppery.
• Alcoholic beverages are contraindicated.
• The basis of the diet should be plant-based foods.
• To speed up wound healing, it is recommended to drink plenty of fluids and eat cereals (porridge).

Sex and sports after removal of a scrotal cyst are contraindicated until the patient has fully recovered. This prohibition is due to the fact that even minor physical activity can lead to injury to the organ, suture divergence and the development of postoperative complications. During the recovery period, nervous strain and stress should be minimized. As a rule, the full rehabilitation period takes about 2-3 weeks.

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Reviews

Based on numerous patient reviews, it can be concluded that surgical treatment of cystic neoplasms has a good prognosis. In 95% of operated patients, discomfort completely disappears and reproductive functions are restored.

Removal of a scrotal cyst is an effective procedure that allows you to maintain men's health. But the treatment will only be effective if you seek medical help in a timely manner. To do this, men should regularly conduct self-examinations, and if pain or any lumps appear, consult a urologist.