Epididymal Cyst Removal

Removal of a fluid-filled collection from the epididymis (sperm-carrying mechanism) alongside your testicle.

• Observation – no intervention if your cyst is small or does not bother you
• Aspiration (drainage) with a needle – this removes the fluid but it will often re-accumulate very quickly and is not a curative treatment

Your urologist will briefly review your history and medications, and will discuss the surgery again with you to confirm your consent.

An anaesthetist will see you to discuss the options of a general anaesthetic or spinal anaesthetic. The anaesthetist will also discuss pain relief after the procedure with you.

We may provide you with a pair of TED stockings to wear, and give you a heparin injection to thin your blood. These help to prevent blood clots from developing and passing into your lungs. Your medical team will decide whether you need to continue these after you go home

• Most commonly we do the procedure under a general anaesthetic (with you asleep) or a spinal anaesthetic (where you are unable to feel anything from the waist down)
• we may give you an injection of antibiotics before the procedure, after you have been checked for any allergies
• we make a small incision into your scrotum and separate the cyst (pictured) from your epididymis and testicle
• removing the cyst interrupts the passage of sperm from the testicle; this may be irreversible and can interfere with your fertility
• we close the skin with dissolvable stitches which will disappear after two to three weeks
• we normally provide you with a scrotal support to wear for the first few days

The possible after-effects and your risk of getting them are shown below. Some are self-limiting or reversible, but others are not. We have not listed very rare after-effects (occurring in less than 1 in 250 patients) individually. The impact of these after-effects can vary a lot from patient to patient; you should ask your surgeon’s advice about the risks and their impact on you as an individual:

Your risk of getting an infection in hospital is between 4 & 6%; this includes getting MRSA or a Clostridium difficile bowel infection. This figure is higher if you are in a “high-risk” group of patients such as patients who have had:

• long-term drainage tubes (e.g. catheters);
• bladder removal;
• long hospital stays; or
• multiple hospital admissions.

• you will get some swelling and bruising of the scrotum which may last several weeks
• you may be uncomfortable for seven to 14 days
• we usually provide you with a scrotal support (“jock strap”) to make the post-operative period more comfortable. If you find this difficult to wear, you can use tight, supportive underwear or cycling shorts
• it is advisable to take some simple painkillers such as paracetamol or ibuprofen to help any discomfort in the first few days
• you may find ice packs helpful to reduce pain and swelling in the first few days after surgery (but do not apply them directly to your skin)
• if your bruising, swelling or pain is getting progressively worse, day- by-day, you should contact your surgical team for advice
• you will be given advice about your recovery at home
• you will be given a copy of your discharge summary and a copy will also be sent to your GP
• any antibiotics or tablets you may need will be arranged & dispensed from the hospital pharmacy
• you should avoid heavy lifting or any other strenuous exercise for at least four weeks
• your stitches will usually disappear after two to three weeks; you should avoid baths, because this can accelerate thir disappearance, but you may shower
• we may arrange a follow-up appointment for you but this is not routine for all patients

Before your procedure

Please tell a member of the medical team if you have:

• an implanted foreign body (stent, joint replacement, pacemaker, heart valve, blood vessel graft);
• a regular prescription for a blood thinning agent (e.g. warfarin, aspirin, clopidogrel, rivaroxaban, dabigatran);
• a present or previous MRSA infection; or
• a high risk of variant-CJD (e.g. if you have had a corneal transplant, a neurosurgical dural transplant or human growth hormone treatment).

Questions you may wish to ask

If you wish to learn more about what will happen, you can find a list of suggested questions called “Having An Operation” on the website of the Royal College of Surgeons of England. You may also wish to ask your surgeon for his/her personal results and experience with this procedure.

Before you go home

We will tell you how the procedure went and you should: 

• make sure you understand what has been done; 
• ask the surgeon if everything went as planned; 
• let the staff know if you have any discomfort; 
• ask what you can (and cannot) do at home; 
• make sure you know what happens next; and 
• ask when you can return to normal activities. 

We will give you advice about what to look out for when you get home. Your surgeon or nurse will also give you details of who to contact, and how to contact them, in the event of problems. 

Smoking and surgery

Ideally, we would prefer you to stop smoking before any procedure. Smoking can worsen some urological conditions and makes complications more likely after surgery. For advice on stopping, you can: 

• contact your GP; 
• access your local NHS Smoking Help Online; or 
• ring the free NHS Smoking Helpline on 0300 123 1044. 

Driving after surgery

It is your responsibility to make sure you are fit to drive after any surgical procedure. You only need to contact the DVLA if your ability to drive is likely to be affected for more than three months. If it is, you should check with your insurance company before driving again.