Treatments and surgeries

TREATMENTS AND SURGERIES | Epididymectomy

An epididymectomy is used to treat severe chronic pain caused by epididymitis. This procedure is used in instances in which non-surgical methods such as anti-inflammatory drugs have failed to alleviate the condition. While a spermatic cord block with Marcaine can be administered to significantly reduce the pain associated with the condition, in some cases, this technique only provides the patient temporary relief.

The epididymectomy procedure is recommended for cases in which chronic epididymitis is severe and the patient is unresponsive to other types of treatment. It may also be used to treat post-vasectomy pain syndrome — a rare but potentially debilitating condition.

As with any medical procedure for treating chronic pain, there’s no guarantee that an epididymectomy will entirely resolve the patient’s pain or discomfort.

The epididymectomy procedure is preceded by a consultation and medical assessment.

This involves a medical questionnaire and a physical examination.

During this initial appointment, the doctor will also explain the procedure to the patient. Generally, the spermatic cord block is scheduled for another day, though in some cases, it can be administered during the first appointment following the consultation and assessment. After the spermatic cord block procedure, an appointment is scheduled for the epididymectomy.

Please note that the epididymectomy procedure can only be performed at Dr. Carlos Marois’s private urology clinic.

What is the epididymis?

The epididymis is a long, coiled tube at the back of the testicle. It contains a duct that receives sperm from the testicle and transports it to the vas deferens. While in the epididymis, sperm undergo the maturation process that makes them mobile and fertile.

Are there alternative epididymitis treatment options?

Simple monitoring is an option when the pain isn’t too severe.

What happens during an epididymectomy procedure?

The surgery begins by making a short incision in the ridge of tissue separating the testicles called the scrotal raphe. This exposes the testicle and allows the surgeon to excise the epididymis and a segment of the vas deferens by careful dissection and electrocautery.

Lastly, the bleeding resulting from the large number of veins at this anatomical site is stopped. Dissolvable stitches are used to close the skin and in some cases a surgical drain is temporarily put in place to reduce the risk of hematoma.

What are the possible risks and complications of an epididymectomy?

Every surgical procedure involves a certain amount of risk. In rare cases, complications from surgery are permanent and non-treatable.

During the operation, the surgeon could encounter an unexpected hindrance and thus need to perform an additional or alternative procedure. Alternatively, the operation may need to be interrupted altogether.

Certain complications are associated with the patient’s general health and with the use of anesthesia. These can arise during any surgical procedure and will be explained to the patient during a pre-operative consultation with the anaesthetist.

Complications directly linked to the operation are rare but possible. These include :

Hematoma. surgical reintervention may be needed to stop the bleeding and drain the hematoma.
Delayed healing. Prolonged treatment may be required.
Infection. Should infection occur, Dr. Marois will administer antibiotics, drain the abscess or offer another appropriate form of treatment. Signs of infection include fever, a discharge at the site of the incision and inflammation of the bursa.
Testicular atrophy. In exceptional cases, this can occur following a hydrocelectomy
Recurrence. The risk of the condition reoccurring is extremely low.

It’s possible that the scrotum will be bluish or blackish for a few days. This is normal: it will recover its normal appearance in two to three weeks. Dissolvable stiches are generally used and will disappear on their own in 12 to 15 days. When the stitches disintegrate, there could be a pus-like discharge: this is normal.

Following the procedure, the patient cannot shower for 24 hours or take a bath for 48 hours. Thereafter, it’s recommended that he bathe every day.

Contact us if you’re suffering from epididymitis and would like to learn more about getting an epididymectomy procedure in Greater Montreal or Quebec City.

Would you like to make an appointment, or do you have any questions? Write to us and we will get back to you as soon as possible!

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Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

Cancellation of appointment:

To ensure the smooth running of the clinic and a minimum of courtesy towards other patients and our staff, we ask you to notify us 48 hours in advance for the cancellation of a consultation, 5 working days in advance for a surgery at the office and 21 working days in advance for a major surgery. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur, so we ask you to provide us with at least a 24-hour notice for any change in their appointment; we will be happy to accommodate you, the best we can. However, if you fail to inform us within this timeframe or do not show up, we will charge a $ 100 fee.

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Dr. Marois is a urologist who is not a member of the Régie de l’Assurance Maladie du Québec (RAMQ). As such, if you require his professional services, you will have to pay directly the Cliniques Marois for the services rendered.

Cancellation Policy:

To ensure the smooth running of the clinics aa well as a minimum of courtesy towards other patients and staff members, we ask you to notify us 48 hours in advance for cancelling an appointment, 5 working days for cancelling a minor surgery in the office and 21 working days for major surgery at the CMC. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur and schedules change, so we ask patients to give us at least a 24-hour notice for any changes of appointment. We will be happy to reschedule another one for you. Failure to provide such notice within this timeframe will result in a $ 100 fee.

Thank you for your understanding.

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