What are the effects of epididymectomy?

Epididymectomy may affect semen storage and maturation functions, but most men can maintain normal fertility after surgery. The main effects include temporary decrease in semen quality, local discomfort, psychological adaptation period, fluctuations in hormone levels and the need for long-term fertility assessment.

1. Changes in semen quality:

The epididymis is an important organ for sperm maturation and storage. After removal, semen volume and sperm motility may decrease in the short term. The contralateral epididymis can compensate for its function after about 3-6 months, and clinical data shows that more than 80% of patients with unilateral resection can return their semen parameters to the normal range. Regular semen analysis monitoring is recommended after surgery.

2. Local discomfort symptoms:

Common reactions such as scrotal swelling and incision pain may occur 1 to 2 weeks after surgery, which are usually related to surgical trauma and local inflammation. Symptoms can be relieved by using a scrotal sling and avoiding strenuous exercise. If testicular swelling or fever persists, infection should be ruled out.

3. Psychological adjustment process:

Some patients have anxiety about fertility, especially those who have had bilateral epididymectomy. The actual natural pregnancy rate after unilateral resection can still reach 60%-70%, and individual fertility status can be clarified through reproductive medicine evaluation. If necessary, you can consult a psychologist to ease your emotions.

4. Hormone level fluctuations:

Epididymal interstitial cells are involved in androgen metabolism, and there may be temporary fluctuations in testosterone levels after surgery, but they can usually adjust and recover on their own within 3 months. A very small number of patients who undergo bilateral resection require hormone levels to be monitored and replacement treatment given if necessary.

5. Fertility assessment:

Those who have had bilateral epididymectomy need to achieve fertility through testicular puncture and sperm extraction combined with assisted reproductive technology. It is recommended to conduct a systematic evaluation 6 months after surgery, including routine semen testing, sex hormone testing and reproductive system ultrasound, and develop an individualized fertility plan based on the results.

You should avoid prolonged sitting and cycling for at least 1 month after surgery, and wear loose cotton underwear to reduce friction. Pay attention to dietary supplements of zinc such as oysters, nuts and vitamin E such as spinach and avocado to promote the repair of the reproductive system. Maintaining moderate aerobic exercise can help improve pelvic blood circulation, but lifting weights and other activities that increase abdominal pressure are prohibited within 3 months. It is recommended to bring complete medical records during regular follow-up visits so that doctors can evaluate the recovery situation. If there is a need for fertility, you can consult a reproductive medicine expert in advance about the feasibility of sperm cryopreservation.