Long-term results of using the sclerotherapy in the epididymal cysts treatment

Abstract

Introduction. In recent years, there has been an increase in the number of patients diagnosed with epididymal cysts (EC). A number of methods have been proposed for their treatment – open surgical interventions, aspiration of cyst contents, sclerotherapy, epididymal cystectomy. In the literature, there are separate works in which attempts were made to study the use of sclerotherapy in the treatment of EC. However, the presented messages are single, there are no data of comparative studies of the use of various methods of treatment of this pathology. The aim of the study was to study the clinical efficacy of sclerotherapy in the treatment of epididymal cysts in terms of long-term indicators. Aim – to study the clinical efficacy of sclerotherapy in the treatment of EC in terms of long-term indicators. Materials and methods. 82 patients with EC aged 18 to 45 years were included in 2 groups: in the treatment of 47 patients in the comparison group, a standard approach was used, in the treatment of 36 patients in the main group, the method of EC sclerotherapy was used. EC sclerotherapy included anesthesia, aspiration of the cyst contents and injection of sclerosant, under ultrasound guidance, puncture of the epididymal cyst was performed, its contents were evacuated, then sclerosant (ethoxysclerol 1% – 2.5 ml) was injected into the cyst cavity with an exposure of 5 min. Results. It was found that during sclerotherapy in the treatment of EC in patients of the main group after the treatment, the dynamics of spermogram indices was more favorable than in the comparison group. In the long-term period (after 6-12 months), these patients had significantly higher levels of ejaculate volume and sperm count, the rate of movement of motile spermatozoa and the proportion of progressively motile spermatozoa than in the comparison group. The use of the sclerosing method increases the clinical efficacy of EC treatment, while the frequency of reproductive events (pregnancy in female partners of patients who underwent sclerotherapy) is 2.7 times higher than in the group where standard surgery was performed. Discussion. Over the past two decades, different authors have proposed different types of sclerosing substances. A number of studies are presented in the literature, the results of which have demonstrated the effectiveness of aspiration and sclerotherapy in the treatment of benign scrotal cysts. A sufficiently high efficiency of EC sclerotherapy was shown. We also found that the use of the sclerotherapy method increases the clinical effectiveness of EC treatment, while the frequency of reproductive events significantly increases. Conclusion. Sclerotherapy is an effective and safe treatment for obstructive azoospermia caused by EC.