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Two weeks ago, I had a schlerotherapy treatment to aspirate one of several spermatoceles I have on my right testicle. Approximately 15 years ago, I had a spermatocelectomy on my left testicle.  I thought I would offer my perspective for those who might find it helpful.

The spermatocelectomy was done primarily for cosmetic reasons as I had no other symptoms prior to the operation.  As a single guy, I did not want to have this issue intrude on my sex life. The pain was quite unpleasant for 3-4 days but the meds did help.  But no guy wants to have ANY pain in his groin ever. I don't recall any other complaints with the recovery, and I have been very pleased with the long-term results. I have developed a small spermatocele on the same (left) testicle but it's small enough that's it's not obvious.  I doubt I will do anything for this unless it increases in size very significantly.

In the meantime, several spermatoceles developed on my right testicle and they reached the size in 2012 where they were very obvious, were causing some minor pain, and continued to increase in size.  I spoke to my urologist approximately 3 times over 2-3 years, and he said schlerotherapy was NOT generally recognized as an appropriate treatment and he did not consider it a treatment option.  He said he could not refer me to another doctor because he did not know any who performed the procedure.  Frankly, I thought he was being old-fashioned and stubborn and sought other doctor's opinions.

I consulted with the top urologist at OSU Medical Center in Columbus, and he did not support schlerotherapy and proposed a spermatocelectomy and possibly removal of my epididymis as the best treatment. Since I wanted to pursue non-surgical treatments, I moved on to a urologist I found in Chicago.

I called the office and they asked me to get a scrotal ultrasound and have it forwarded to them.  Eventually, I had an appointment even though the doctor's assistant told me I was not a good candidate based on the images the doctor reviewed. When I met the doctor in person, he said one of my spermatoceles could be aspirated, so I agreed to that as a short-term fix to reduce the obvious swelling and perhaps reduce the discomfort.

The procedure was OK though it seemed a little disorganized to me. The doctor did not return to see me after the procedure and I consider that a serious lapse of judgment on his part.  I should have insisted that he return when the nurse had trouble answering my questions but was too flustered to think straight at that point. 

At home I had significant bruising and some discomfort. There was some pain but it subsided completely after about 3 days. I used a couple of hydrocodone during that period, maybe 3-4 total.  After a week, the swelling reduced significantly, and I actually had a mostly normal-looking testicle for a few days (approx. 7-10 days after the procedure). On the 12th day when I woke up, I noticed my testicle was the same size, or maybe larger than it was prior to the schlerotherapy.  I called the doctor's assistant and she assures me it's quite common for patients to have significant improvement followed by a recurrence of the swelling. She said it's typically followed by a gradual reduction in the swelling over a longer period of time.

That's were I'm at now. Waiting...

 

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So....what happened? Finish your story please! Would you recommend sclerotherapy, in your experience?

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I would recommend sclerotherapy only if the urologist does NOT inject doxycycline into the testicle after the procedure. In my case, the reaction resulted in development of considerable scarring that made testicle as large as it was before. Otherwise, I recommend a spermatocelectomy because the final surgical outcome is not contingent on how much scarring develops. The procedure is more invasive but the result is more predictable.

In my case, I opted for a spermatocelectomy subsequently to clean things up. My urologist said there was no way to do the procedure because there were too many separate 'pockets'. He did an epididyectomy leaving me with a tiny right testicle and less than half the sperm/seminal fluid when I ejaculate than prior to epididyectomy.
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Thanks so much for your reply!
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