Decompression Epididymectomy: A Safe and Effective Approach to Localized Scrotal Content Pain

C. Mallory, A. Krishingner, K. Campbell

Decompression epididymectomy, epididymectomy, epididymitis, scrotal pain

This video describes our novel approach to decompression epididymectomy. Feared complications of epididymectomy include injury to the testicular or gonadal vessels which lie near the epididymis, resulting in testicular atrophy, devascularization and loss. We describe a safe, effective and reproducible surgical approach to mitigate these inherent risks. The approach includes unroofing the epididymal tunica, allowing for improved visualization of the epididymis, aiding in the systematic disarticulation of the epididymis. Importantly, the posterior epididymal fascia which is kept in-situ, overlying the testis and gonadal vasculature. Epididymitis is likened to a compartment syndrome, therefore we find that decompressing this space, prior to a systematic disarticulation of the epididymis, is an effective strategy to alleviate chronic epididymal discomfort. We propose that the decompression epididymectomy is technically feasible and safe alternative to the standard epididymectomy.

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