What are the sequelae after epididymectomy?

Scrotal swelling, chronic pain, decreased fertility, effects on sexual function and psychological adjustment problems may occur after epididymectomy. The degree of sequelae is closely related to the surgical method and individual recovery. Most patients can gradually alleviate it through standardized care.

1. Scrotal swelling:

About 60% of patients will develop scrotal hematoma or edema within 72 hours after surgery, which is related to obstruction of lymphatic return and incomplete intraoperative hemostasis. It is recommended to use a scrotal band to lift the area, and then apply ice for 48 hours before applying heat to promote absorption. If the swelling lasts for more than 1 week and the skin becomes red and hot, the possibility of infection needs to be ruled out.

2. Chronic pain:

5%-15% of patients develop chronic scrotal pain after surgery, mostly caused by nerve ending damage or scar adhesion. Mild pain can be relieved by low-frequency heat therapy and sitz baths, while nerve block treatment should be considered for persistent severe pain. Pain assessment should differentiate between incisional pain and referred testicular pain, which may indicate complications such as spermatic cord torsion.

3. Fertility effects:

Unilateral ablation has little effect on total semen volume, but bilateral ablation can lead to azoospermia. The epididymis is the place where sperm are matured and stored. Even if the vas deferens is unobstructed after removal, the sperm survival rate may still drop by 30%-50%. Those with fertility needs are advised to cryopreserve sperm before surgery and conduct routine semen review 3 months after surgery.

4. Changes in sexual function:

Some patients experience reduced ejaculation volume or decreased pleasure after surgery, which is related to changes in semen composition. Epididymal fluid accounts for 30% of the total semen volume, and its absence may affect the quality of ejaculation. Most patients can adapt through compensatory mechanisms within 6 months. In severe cases, you can consult an andrologist for pelvic floor muscle training.

5. Psychological adjustment:

About 20% of patients experience anxiety or body image disturbance after surgery, especially young patients who have obvious concerns about their fertility. It is recommended to join a patient support group and receive psychological counseling if necessary. Clinical data shows that 90% of patients can return to baseline levels in psychological evaluation 1 year after surgery.

Avoid strenuous exercise and heavy physical labor for 3 months after surgery, and wear loose cotton underwear to reduce friction. Pay attention to supplementing the diet with zinc, oysters, pumpkin seeds, vitamin E, nuts, and spinach to promote tissue repair, and perform moderate aerobic exercise every week to improve pelvic blood circulation. Regularly review the spermatic cord ultrasound to monitor the status of the contralateral testis. If persistent fever or abnormal induration occurs, timely medical treatment is required. Long-term follow-up showed that there was no significant difference between the quality of life scores of patients under standard care and those before surgery.