Removal of the scrotum cyst

The scrotal cyst is a fairly common disease. For treatment, surgical methods, that is, removal, are used. Consider the types of operations and their features.

According to medical statistics, cystic scrotal formation is detected in 30% of patients who underwent ultrasound examination of this organ. Tumor lesions of the appendages of the testes and seminal coils do not have a pronounced clinical picture. It is the appearance of painful sensations that is the reason to turn to the urologist-andrologist and undergo diagnostics.

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

D10-D36 Benign neoplasm.

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

Cystic lesions occur at any age. There are such organ tumors:

1. The cyst of the epididymis (spermatoceles) - arises from the violation of the outflow of the secretion from the epididymis. Benign hollow formation is oval in shape and located in a fibrous capsule, which is not associated with surrounding tissues.
2. The cyst of the spermatic cord (funiculocele) is formed when a serous secretion is accumulated between the leaves of the sheath of the spermatic cord. It appears palpable spherical formation, which is not soldered with the testicle or appendage. Causes aching pain in the scrotum, intensifying with physical activity.

Conservative therapy is ineffective, so patients are shown surgery. Surgical intervention consists in removing the cyst without breaking its shell. Later on, the epididymis is sutured.

[1], [2], [3]

Indications for the procedure

Cysts of the scrotum occur at any age, but more often in boys at 7-14 years of age. This is due to puberty and the active formation of genital organs.

The main symptomatology:

• Abnormal enlargement of the scrotum.
• Pronounced pain with physical activity.
• Edema and redness of tissues.
• Increased body temperature.
• General weakness.

The tumor has a benign character, but despite this requires surgical treatment. Indications for removal are painful sensations due to tissue proliferation. In some cases, the liquid in fibrous formation undergoes infectious processes, causing inflammation and severe pain.

The main reasons for the removal of the scrotal cyst:

• Neoplasm slowly increases in size, but gradually stretches the tissues of the scrotum, causing a significant cosmetic defect.
• Trauma to the inguinal area can lead to rupture of the cyst.
• Deformation of the scrotum tissues.
• Development of malignant process due to a sharp increase in the tumor and its compaction.
• Dysfunction of the excretory ducts of spermatozoa.

Surgery is indicated if the cyst is more than one centimeter in diameter. To clarify its size, ultrasound is performed, with which you can see the boundaries of the cyst well.

[4], [5], [6], [7]

Preparation

Removal of the scrotum requires special training. At the first stage, the patient is physically examined. The doctor examines and probes the affected organ, collects an anamnesis. At the next stage, instrumental methods are assigned:

• Diaphanoscopy - with the help of X-ray, the doctor evaluates the passage of light rays through the scrotum tissue. If there is a cyst with a liquid, then it glows pink.
• Ultrasound examination is necessary to determine the size and location of the tumor.
• MRI of the pelvic organs - with its help receive a layered image of tissues, which allows you to more accurately determine the nature of the tumor.

In some cases, a testicular biopsy with histology and blood tests for oncomarkers are prescribed. 2 weeks before surgery, patients are prescribed antibacterial drugs from the group of fluoroquinolones.

[8]

Technique of the removal of scrotal cyst

Conservative therapy of the scrotum cyst 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 peculiarities of the technique of performing the operation to remove the scrotal cyst.

1. Surgical removal

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

2. Sclerotherapy

This method is the removal of neoplasm by introducing a chemical substance into the cystic cavity, which promotes the gluing of its walls. Using a syringe, the cyst is cleaned of serous fluid and a medication is injected into the cavity. Due to this, the tissues lining the interior are destroyed (sclerized).

This method is carried out in the event that a man does not plan to have children in the future. This is due to the fact that the procedure can be complicated by gluing the spermatic cord.

3. Laparoscopy

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

The advantages of the method:

• It does not take much time.
• Has a minimal risk of 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. On the scrotum impose a special bandage for her immobilization. Also, anti-inflammatory drugs and a diet are prescribed to speed recovery.

4. Punctuation

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

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

Contraindications to the procedure

Like any surgery, surgical removal of the scrotum cyst has certain contraindications to the conduct, consider them:

• Severe pathology from the cardiovascular or respiratory system.
• Blood poisoning.
• Purulent peritonitis.
• Terminal states.
• Recently transferred cavitary operations.
• Early childhood of the patient (high risk of complications after anesthesia).
• Obesity is extreme.
• Blood clotting disorders.
• Severe hemodynamic disorders.
• Infectious and inflammatory processes in the body.
• Malignant neoplasms.

Intolerance of chemical drugs used for sclerotherapy and medications used for anesthesia is also taken into account.

[9], [10], [11]

Consequences after the procedure

Postoperative behavior of the patient largely determines the risk of development of consequences after the procedure of removal of the cyst. Surgical intervention can lead to such problems:

• Formation of scars and tumors on the scrotum.
• Strong puffiness.
• Bacterial infection of the wound.
• Hematomas.
• Increased sensitivity of the scrotum.
• Infertility (gluing of spermatic cord with sclerotherapy).
• Recurrent neoplasm.

To reduce the risk of these consequences, all medical appointments must be observed. In the first days after the operation, a complete peace and stillness is shown. On the operated organ impose a supporting bandage. To avoid edema, the patient is shown rest on his back, so that the organ is in an elevated state.

The patient should regularly arrange compresses with ice or cold water. It is also contraindicated to remove the wound dressing yourself, any sexual contacts, hot baths and physical exertion. To speed up recovery, a special diet is prescribed. Non-compliance with postoperative recommendations may cause injury to the operated area. Because of this, the restoration process will be significantly delayed.

[12], [13], [14]

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 postoperative complications:

• When penetrating into the scrotum of an infection, purulent-inflammatory processes begin. The organ increases in size, swells and reddens. When you touch the tissues there are severe pains.
• If the operation is carried out by a urologist with insufficient experience, there is a risk of mechanical damage to the spermatic cord. This leads to the rupture of the capsule of the cyst and the ingestion of its serous fluid into the scrotum. As a result, a severe inflammatory process develops.
• With 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 if the problem is not treated in a timely manner, when the neoplasm becomes so large in size that it compresses the vas deferens, disrupting the passage of sperm and reproductive function.

Timely appeal for medical care and the right type of surgical treatment can avoid the aforementioned complications.

[15]

Care after the procedure

Treatment of the scrotal cyst requires strict adherence to postoperative rules. Care after the procedure consists of:

• Bed rest for 3 days with superimposed cold compresses (relieve edema and reduce pain).
• Wearing a compression lingerie / bandage, in order for the testicles to occupy an anatomically correct position.
• Refusal of any physical exertion until complete resorption of the joints.
• Reception of medicines prescribed by a doctor (antibiotics, anti-inflammatory drugs, analgesic).

Important in the process of recovery is nutrition and supply of the body with useful substances. To increase the protective properties of the immune system, vitamin complexes are indicated. As for the diet, it is aimed at restoring the reproductive system and consists of such recommendations:

• It is forbidden to overeat. To eat it is necessary small portions during the day. A day should be about five small meals.
• Food should be as gentle as possible, not greasy, not salty and not peppery.
• Alcoholic beverages are contraindicated.
• The basis of the diet should be products of plant origin.
• To accelerate the healing of wounds recommended abundant drinking and eating cereals (porridge).

Sex and sports after removal of the cyst of the scrotum are contraindicated until the patient is completely restored. This ban is due to the fact that even minor physical exertion can lead to injury to the body, divergence of seams and the development of postoperative complications. At the time of recovery, nervous overload and stresses should be minimized. Typically, a full rehabilitation period takes about 2-3 weeks.

[16]

Reviews

According to numerous reviews of patients, it can be concluded that the surgical treatment of cystic neoplasm has a good prognosis. 95% of the patients undergoing surgery completely discomfort and reproductive functions are restored.

Removing the scrotal cyst is an effective procedure that helps to maintain male health. But the treatment will be effective only if you seek medical help in a timely manner. For this, men should regularly perform self-examination, and if pain or any seals occur, seek advice from a urologist.