Epididymectomy: Questions About Surgery and Fertility

Questions about epididymectomy?

Hello Doctor: I previously had inflammation of the left epididymis, and although my urine tests showed no bacteria, there was some swelling.
After that, I experienced occasional soreness for a whole year.
Recently, the epididymitis has recurred, and the doctor prescribed antibiotics, pain relievers, and anti-inflammatory medication.
I found information online about epididymectomy and would like to ask the doctor: 1.
Does it mean removing the epididymis? 2.
Will the testicle be left intact? 3.
Will removing the epididymis affect testicular function? 4.
Will fertility be reduced?

Peng, 20~29 year old female. Ask Date: 2020/02/15

Dr. Sun Hongshun reply Urology

Hello, please be reminded that acute epididymitis, if treatment with antibiotics is stopped prematurely, can lead to incomplete treatment and may result in recurrent episodes, potentially progressing to chronic epididymitis.
In severe cases, it can lead to abscess formation or may become untreatable, necessitating surgical intervention such as incision and drainage or epididymectomy.
This is more commonly seen in elderly individuals or those with compromised immune systems.
It is advisable to continue follow-up appointments and adhere to the prescribed medication regimen.

Reply Date: 2020/02/15

More Info

Epididymectomy is a surgical procedure that involves the removal of the epididymis, which is a coiled tube located at the back of each testicle. This structure plays a crucial role in the maturation and storage of sperm. Your questions about this surgery and its implications for fertility are very important, and I will address each of your concerns in detail.

1. What does epididymectomy entail?
Yes, an epididymectomy refers to the surgical removal of the epididymis. This procedure is typically performed when there are persistent issues such as chronic epididymitis (inflammation of the epididymis), abscess formation, or other complications that do not respond to conservative treatments. The surgery can be done unilaterally (removing one epididymis) or bilaterally (removing both), depending on the patient's condition.

2. Will the testicle remain intact?
Yes, during an epididymectomy, the testicle itself is left intact. The surgery focuses solely on the epididymis, which means that the testicular tissue responsible for sperm production remains functional. This is crucial because the testicles are the primary organs responsible for producing sperm and testosterone.

3. Will the removal of the epididymis affect testicular function?
The removal of the epididymis does not directly affect the testicular function in terms of sperm production. The testicles will continue to produce sperm, but the removal of the epididymis means that the sperm will not be able to mature and be stored in the epididymis. This can lead to some changes in sperm transport, but it does not eliminate the ability to produce sperm.

4. Will fertility be affected?
Fertility may be impacted, but it largely depends on the extent of the underlying condition and whether the other epididymis is functioning normally. If only one epididymis is removed and the other remains intact, many men can still father children, as the remaining epididymis can still store and transport sperm. However, if both epididymides are removed, or if there are other issues affecting sperm production or transport, fertility could be compromised.

In summary, while an epididymectomy involves the removal of the epididymis, it does not directly impair testicular function or the ability to produce sperm. However, it can affect the maturation and transport of sperm, which may have implications for fertility. If you are concerned about your fertility after this procedure, it is advisable to discuss this with your healthcare provider. They may recommend a semen analysis to assess your sperm production and quality post-surgery.

Additionally, it is important to consider that recovery from surgery can take time, and any pain or discomfort you are experiencing should be monitored. If you continue to have issues with pain or recurrent infections, further evaluation may be necessary to determine the best course of action for your reproductive health. Always keep an open line of communication with your healthcare provider regarding your concerns and any symptoms you may experience.

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