Cysts connected with the epididymis 1 Types Cysts

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Cysts connected with the epididymis 1

Cysts connected with the epididymis 1

Types • Cysts of the epididymis • Spermatocele 2

Types • Cysts of the epididymis • Spermatocele 2

Cysts of the epididymis • Congenital, derived from an embryonic remnant around the epididymis

Cysts of the epididymis • Congenital, derived from an embryonic remnant around the epididymis • Filled with crystal clear fluid 3

Cysts of the epididymis: clinical features • Found during middle life • Usually bilateral

Cysts of the epididymis: clinical features • Found during middle life • Usually bilateral • Cysts: – – Located behind the body of the testis Tense (aggregation of a number of small cysts like bunch of tiny grapes) Fluctuation difficult appreciate Transillumination: Chinese lantern pattern 4

Cysts of the epididymis: D/D • Cysts of the appendages of the testis 5

Cysts of the epididymis: D/D • Cysts of the appendages of the testis 5

Cysts of the epididymis: T/t • If small no T/t is needed • Surgical

Cysts of the epididymis: T/t • If small no T/t is needed • Surgical if the cyst is large & causing discomfort • Aspiration is useless, as these cysts are usually multilocular 6

Spermatocele • • Acquired Unilocular Retention cyst Cysts contain fluid resembling barley – water

Spermatocele • • Acquired Unilocular Retention cyst Cysts contain fluid resembling barley – water containing spermatozoa 7

Spermatocele: clinical features • Scrotal swelling – Location: head of the epididymis, above &

Spermatocele: clinical features • Scrotal swelling – Location: head of the epididymis, above & behind the body of testis – Testis can be felt separately from the body of the testis – Soft – Fluctuation: usually positive – Transillumination test: negative 8

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Testicle (grey) and Spermatocele (black) 10

Testicle (grey) and Spermatocele (black) 10

Spermatocele: T/t • Aspiration • Excision of the cyst 11

Spermatocele: T/t • Aspiration • Excision of the cyst 11