Spermatotsele (seed cyst) – the band formation of a small egg or its appendage limited to a fibrous cover and containing semen, spermatotsita and spermatozoa. Because of the small size and slow growth to a spermatotsela usually proceeds asymptomatically, in rare instances there is pressure and painful feelings in a scrotum. The main methods of diagnostics to a spermatotsela are survey and a palpation of a scrotum by the doctor-urologist, ultrasonography and a diafanoskopiya. Treatment to a spermatotsela at the big sizes of a cyst can include surgical excision, tonkoigolny aspiration, sclerotherapy.
Spermatotsele is formed because of violation of normal outflow of a secret of an appendage of a small egg and its accumulation in an output channel with formation of a pathological cavity in the field of a head or a tail of an appendage and a seed kanatik. Spermatotsele is defined to the touch as the roundish, smooth, plotnoelastichny, painless education located in a scrotum over a small egg. Contents can be presented to a spermatotsela by a transparent or molokopodobny secret which part semen, seed cages, spermatozoa, fatty little bodies, cages of an epithelium and single leukocytes is. Spermatotsele can be congenital and acquired, about 7% of diseases of a scrotum fall to his share in urology.
Spermatotsele is good-quality education, is often shown during active changes of gonads (6-14 years, 40-50 years).
Reasons for a spermatotsela
Formation congenital to a spermatotsela comes from embryonic rudiments of myullerovy channels () and is connected with a partial nezarashcheniye of a vaginal shoot of a peritoneum at which on the course of an appendage of a small egg and a seed kanatik there are not reported cavities. Congenital to a spermatotsela usually has the small sizes (2-2,5 cm) and contains transparent light yellow liquid without impurity of spermatozoa.
In case of acquired to a spermatotsela damage of output seed channels arises because of a trauma or inflammatory diseases of bodies of a scrotum (a vezikulit, an orkhit, an epididymite, a deferentit). The injured or inflammatory changed channels owing to obstruction stop functioning. Removal of a seed secret does not happen, it overflows a channel, stretching its walls and forming a cyst. Acquired to a spermatotsela can be one - and multichamber, with various contents: dense, dairy color or transparent opalestsiruyushchy, with impurity of spermatozoa and seed cages.
Symptoms to a spermatotsela
Often to a spermatotsela proceeds asymptomatically and slowly increasing in a size, does not cause disorders of sexual and reproductive function in men. At the spermatotsel it is possible to probe incidentally painless spherical education in the top part of a scrotum.
In case of achievement patients show to a spermatotsela of the big sizes complaints to increase in the sizes of a scrotum, discomfort, weight and pain at the movements, walking, sitting, sexual intercourse. The spermatotsela can carry a gap and suppuration of a seed cyst to possible complications.
Diagnostics to a spermatotsela
At visual survey of a scrotum the spermatotsela of the big size can find contours; the palpation allows to feel the painless elastic education located over a small egg and isolated from it. Tool methods of diagnostics to a spermatotsela - the diafanoskopiya and ultrasonography of a scrotum in most cases give the chance quickly and well to carry out diagnostics of this state.
Diafanoskopiya is applied in andrology to recognition of nature of formations of a scrotum by its raying by beams of the passing light. The scrotum luminescence red light shows that light completely passes through fabrics and the available education is filled with liquid. Unlike tumors of a small egg and its appendage to a spermatotsela freely passes light.
Ultrasonography of a scrotum allows to make the diagnosis to a spermatotsela with the largest accuracy. By results of ultrasonography it is possible to define an arrangement of a seed cyst and to estimate its sizes. Ekhoskopicheski to a spermatotsela is defined as the uniform education having a thin wall with equal and accurate contours. For differential diagnostics to a spermatotsela with tumoral processes sometimes carry in addition out a magnetic and resonant or computer tomography. Difdiagnostika to a spermatotsela is carried out with tumors (cancer of a small egg and appendage), a dermoidny cyst of a small egg and to the gidrotsela.
Treatment to a spermatotsela
At an asymptomatic current and the insignificant size to a spermatotsela of special treatment waiting tactics is not required, applied. At the increase in a scrotum causing discomfort and a pain syndrome due to deformation of surrounding fabrics excision of a cyst of an appendage of a small egg is necessary in the surgical way. As medicinal therapy at the spermatotsel for removal of pain and discomfort use analgetics and resolvents.
Spermatotselektomiya (removal of a cyst of an appendage of a small egg) – microsurgery which is carried out in out-patient conditions under local anesthesia. Surgery is carried out under optical increase through a small section of skin on a forward surface of a scrotum to areas over a small egg. The cyst is vylushchivat, leaving not changed fabric of a small egg and its appendage unaffected. The obligatory morphological research of contents to a spermatotsela is conducted.
After a spermatotselektomiya to the patient on 2 or more than a day impose suspenzoriya for maintenance of a scrotum. It is recommended to put during the first days ice for elimination of a swelling and prevention of hematomas. Less often for treatment to a spermatotsela use palliative methods: needle aspiration and sclerotherapy. Aspiration to a spermatotsela is carried out by means of a puncture most the speaker of the site of a scrotum by a special hollow needle, if necessary under ultrasonography control.
At sclerotherapy after removal of liquid contents of a cyst the injection of special solution (sklerozant) directly in a cavity to a spermatotsela with the subsequent massage of a scrotum for more uniform distribution of medicine is carried out. Sclerotherapy promotes pasting of walls to a spermatotsela and the termination of accumulation of liquid in it. Within a month after intervention on a scrotum observation at the urologist is shown.
Forecast and prevention to a spermatotsela
The forecast after a spermatotselektomiya, as a rule, favorable: gradually visible cosmetic defect disappears, the genital function broken to a spermatotsela is restored. Seldom after surgeries on a scrotum bleeding, small egg dropsy, the expressed cicatricial process, impassability of semyavynosyashchy ways and infertility (is possible at damages of the semyavynosyashchy channels or vessels of a small egg breaking processes of maturing and transport of sperm). Besides, after aspiration and sclerotherapy at the spermatotsel the disease recurrence therefore these methods it is limited is not excluded are applied at men of reproductive age.
At suspicion on a recurrence the spermatotsela needs to execute diagnostic ultrasonography of a scrotum. Spermatotsele at bilateral defeat of appendages of a small egg and enough rapid growth can squeeze normally working channels and lead to infertility. For prevention the spermatotsela should avoid injuries and inflammations of bodies of a scrotum, regularly to carry out self-inspection and to address in due time experts at detection of additional educations.