Epididymal Cysts in Childhood - Conservative or Surgical Approach?

• Authors: Jerzy Niedzielski , Mieczysław Miodek , Marek Krakós
• Languages of publication: EN

Abstracts

EN

The aim of the study. To decide on the accurate way of treatment and to establish criteria for operation in boys with pubertal epididymal cysts (ECs).Material and methods. Results of scrotal ultrasound of 363 boys and adolescents, aged 2 months to 18 years, were reviewed retrospectively.Results. Of all 363 patients with scrotal ultrasound 59 (16.2%) at mean age of 14.03 yrs had ECs. The EC incidence increased with age and 42 out of 124 boys (33.8%) older than 14 yrs had cysts (chi2=27.627, p=0.000). Out of 59 patients, in 30 (50.8%) cysts were diagnosed incidentally at the time of scrotal US, 29 boys (49.2%) presented with scrotal mass and/or pain. 31 patients with ECs (52.5%) underwent elective surgery and the remaining 28 boys (47.5%) received conservative treatment. The age of boys with ECs who underwent surgery ranged from 8 to 18 years (mean 14.32). The age range of patients treated conservatively was 7-18 (mean 13.71). There was no statistical difference in age between boys treated surgically and conservatively (t=0.924, p=0.36). ECs resolved in 17 patients out of 28 boys treated conservatively, in remaining 11 boys the size of cysts was stabile and they remain asymptomatic. Clinical and ultrasonographic follow-up were carried out from 11 months to 5 years.Conclusions. ECs are more common in older boys (over 14 years). Management of ECs smaller than 10 mm should be conservative with clinical and ultrasound controls, leaving surgery for cysts increasing in size over 10 mm which did not involute with time.

Keywords

EN

epididymal cysts; childhood; scrotal ultrasound; operation; conservative treatment

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 8
• Pages: 406-410

Dates

published

1 - 8 - 2012

online

17 - 9 - 2012

Contributors

author

Jerzy Niedzielski

• Department of Pediatric Surgery and Urology, Chair of Pediatric Surgery, University School of Medicine in Łódź, University Children's Hospital, No 4 in Łódź

author

Mieczysław Miodek

• Department of Pediatric Surgery and Urology, Chair of Pediatric Surgery, University School of Medicine in Łódź, University Children's Hospital, No 4 in Łódź

author

Marek Krakós

• Department of Pediatric Surgery and Urology, Chair of Pediatric Surgery, University School of Medicine in Łódź, University Children's Hospital, No 4 in Łódź

References

• Chillón Sempere FS, Domínguez Hinarejos C, Serrano Durbá A et al.: Epididymal cysts in childhood. Arch Esp Urol 2005; 58(4): 325-28.
• Homayoon K, Suhre CD, Steinhardt GF: Epididymal cysts in children: natural history. J Urol 2004; 171(3): 1274-76.
• Posey ZQ, Ahn HJ, Junewick J et al.: Rate and associations of epididymal cysts on pediatric scrotal ultrasound. J Urol 2010; 184(4 Suppl): 1739-42. Epub 2010 Aug 21.
• Jelloul L, Billerey C, Ait Ali Slimane M et al.: Epididymal cysts in adolescents. Ann Urol 1999; 33(2): 104-08.
• Walsh TJ, Seeger KT, Turek PJ: Spermatoceles in adults: when does size matter? Arch Androl 2007; 53(6): 345-48.[PubMed][WoS][Crossref]
• Lee JC, Bhatt S, Dogra VS: Imaging of the epididymis. Ultrasound Q 2008; 24(1): 3-16.[Crossref]
• Muttarak M, Chaiwun B: Painless scrotal swelling: ultrasonographical features with pathological correlation. Singapore Med J 2005; 46(4): 196-201.
• Kalina-Faska B, Januszek-Trzciakowska A, Kalina M et al.: Ultrasound examination of the scrotum in boys. Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw 2002; 8(1): 35-40.
• Woodward PJ, Schwab CM, Sesterhenn IA: From the archives of the AFIP: extratesticular scrotal masses: radiologic-pathologic correlation. Radiographics 2003; 23(1): 215-40.[Crossref][PubMed]
• Vick CW 3rd, Klein FA, Schneider V: Adenomatoid tumor of epididymis simulating benign cyst on scrotal ultrasound. Urology 1991; 38(4): 369-71.[Crossref]
• Blau H, Freud E, Mussaffi H et al.: Urogenital abnormalities in male children with cystic fibrosis. Arch Dis Child 2002; 87(2): 135-38.
• Joerger M, Koeberle D, Neumann HP et al.: Von Hippel-Lindau disease-a rare disease important to recognize. Onkologie 2005; 28(3): 159-63.[Crossref]
• Belet U, Danaci M, Sarikaya S et al.: Prevalence of epididymal, seminal vesicle, prostate, and testicular cysts in autosomal dominant polycystic kidney disease. Urology 2002; 60(1): 138-41.[Crossref]
• Conley GR, Sant GR, Ucci AA et al.: Seminoma and epididymal cysts in a young man with known diethylstilbestrol exposure in utero. JAMA 1983; 11, 249: 1325-26.
• Sigurdsson T, Johansson JE, Jahnson S et al.: Polidocanol sclerotherapy for hydroceles and epididymal cysts. J Urol 1994; 151(4): 898-901.
• Freedman D: A lovely bunch of coconuts. Scand J Urol Nephrol Suppl 1991; 138: 227-29.
• Braslis KG, Moss DI: Long-term experience with sclerotherapy for treatment of epididymal cyst and hydrocele. Aust N Z J Surg 1996; 66(4): 222-24.[PubMed]
• Tammela TL, Hellström PA, Mattila SI et al.: Ethanolamine oleate sclerotherapy for hydroceles and spermatoceles: a survey of 158 patients with ultrasound followup. J Urol 1992; 147(6): 1551-53.
• Masuda H, Yamada T, Nagahama K et al.: Three cases of cystic testicular disease: simple cyst of the testis, cyst of the tunica alubuginea and mature cystic teratoma. Hinyokika Kiyo 1993; 39(3): 265-68.
• Heidenreich A, Engelmann UH, Vietsch HV et al.: Organ preserving surgery in testicular epidermoid cysts. J Urol 1995; 153(4): 1147-50.[WoS]
• Reinberg Y, Manivel JC, Llerena J et al.: Epidermoid cyst (monodermal teratoma) of the testis. Br J Urol 1990; 66(6): 648-51.
• Gunaydin G, Ozyurt C, Kocak I et al.: Antibacterial activity of the fluid contents of spermatoceles and epididymal cysts. Br J Urol 1995; 75(1): 68-70.
• Yilmaz E, Batislam E, Bozdogan O et al.: Torsion of an epididymal cyst. Int J Urol 2004; 11(3): 182-83.[Crossref]

Identifiers

DOI

10.2478/v10035-012-0068-2