What are the effects of cutting off the epididymis?

Epididymectomy surgery may have a certain impact on fertility and sexual function. The specific performance is closely related to individual differences, scope of surgery and postoperative care. Major effects include reduced sperm storage function, reduced fertility, fluctuations in hormone levels, impairment of psychological adjustment, and risk of postoperative complications.

1. Sperm storage disorders:

The epididymis is a key organ for sperm maturation and storage. Removal of the epididymis will cause the sperm produced by the testicles to be unable to be stored and mature further. Unilateral excision may preserve some fertility, but bilateral excision will cause permanent azoospermia. Postoperative semen analysis often shows a reduced or complete absence of sperm, necessitating assisted reproductive technology to achieve fertility.

2. Changes in fertility:

Surgery directly affects the probability of natural pregnancy. About 30%-40% of patients with unilateral resection may have fertility difficulties, and those with bilateral resection basically lose the possibility of natural fertility. It is recommended to cryopreserve sperm before surgery, and testicular puncture and sperm collection combined with in vitro fertilization can be used to solve fertility problems after surgery. Loss of the epididymis does not affect erectile function but may reduce ejaculate volume.

3. Fluctuations in hormone levels:

Surgery may temporarily interfere with testosterone secretion. About 15% of patients experience short-term decreases in testosterone levels, manifesting as symptoms such as loss of sexual desire and fatigue. Most patients recover through compensatory mechanisms within 3-6 months, and severe cases require hormone replacement therapy. Regular testing of six sex hormones can help evaluate endocrine function.

4. Psychological adaptation issues:

20%-35% of patients experience anxiety or depression after surgery, especially young men who are concerned about their fertility are more likely to suffer from psychological stress. It is recommended to receive professional psychological counseling before surgery and participate in a support group after surgery. Your partner's understanding and support are crucial to psychological adjustment. If necessary, you can seek guidance from a psychosexual therapist.

5. Risk of complications:

Common postoperative problems include scrotal hematoma in about 8%, wound infection in 3%-5%, and chronic pain in 2%. Fine microsurgery can reduce the probability of complications. The wound needs to be kept clean and dry after surgery, and strenuous exercise should be avoided for 2-4 weeks. In rare cases, testicular atrophy may occur, requiring regular ultrasound review.

Within 3 months after surgery, you should avoid high temperature environments such as saunas and long hot baths, and wear loose underwear to reduce scrotal compression. Pay attention to dietary supplements such as zinc, oysters, nuts, vitamin E, dark vegetables and other nutrients. Moderate aerobic exercise can help promote blood circulation. Regularly review semen routine, sex hormones and scrotal ultrasound. If persistent pain or fever occurs, seek medical attention promptly. Assisted reproductive technology consultation is recommended 6 months after surgery to accurately assess fertility recovery.