What are the effects of removing 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. The main effects include decreased sperm storage function, temporary reduction in fertility, local discomfort, fluctuations in hormone levels and psychological adjustment problems.

1. Fertility:

The epididymis is an important organ for sperm maturation and storage. The contralateral epididymis can compensate for some of its functions after unilateral resection, but bilateral resection may cause sperm to fail to mature normally. Postoperative semen analysis often shows a decrease in sperm motility, and the chance of natural conception is reduced by about 30%-50%. It is recommended that those with fertility needs cryopreserve sperm before surgery.

2. Changes in sexual function:

The surgery itself will not directly damage the erectile nerve, but about 15% of patients will experience temporary ejaculation pain or diminished pleasure, which is related to surgical scar formation. Most patients gradually recover within 3-6 months. If sexual dysfunction persists, chronic pain or psychological factors need to be investigated.

3. Local discomfort:

Scrotal swelling or pulling pain is common within 3 months after surgery, which is related to lymphatic drainage disorder and local adhesion. Strenuous exercise may aggravate symptoms, so it is recommended to wear a scrotal brace and avoid sitting or standing for long periods of time. If the pain lasts for more than six months, you need to be alert to chronic epididymitis or neuralgia.

4. Hormonal effects:

Epididymal interstitial cells are involved in testosterone metabolism, and temporary fluctuations in androgen levels may occur after resection. Clinical manifestations include loss of sexual desire or mood swings. Usually, the hypothalamic-pituitary-gonadal axis can adjust and recover on its own after 6-8 weeks. In severe cases, six hormone tests are required.

5. Psychological adaptation:

20%-30% of patients experience anxiety or body image disorder after surgery, especially young unmarried men. It is recommended to participate in professional psychological counseling. Partner participation in the recovery process can significantly improve psychological adjustment. Actual surveys show that 90% of patients can fully adapt to life changes one year after surgery.

High-intensity exercise and sex should be avoided for 3 months after surgery, and loose cotton underwear should be worn to reduce friction. Pay attention to supplementing the diet with zinc, oysters, pumpkin seeds, vitamin E, nuts, and deep-sea fish to promote the repair of the reproductive system. Regularly review semen quality and hormone levels, and assistive reproductive technology may be considered for those with fertility difficulties. If persistent pain or fever occurs, infection needs to be ruled out promptly. Systemic functional assessment is more accurate one year after surgery.