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1. There is usually only mild pain after removal of epididymal cysts or variciceles. Yes, the doctor can inject long-acting numbing medicines to help ease post-operative pain.
2. Yes, both the cysts and the varicocele can be removed during the same surgical encounter. Surgery duration would depend upon the number of structures to be removed, but are generally a relatively short surgery, generally lasting about 1-2 hours.
3. Yes, the surgeon can prescribe anxiety medicines prior to the procedure. It is up to the professional discretion of the surgeon whether the medicine is justified. There also should be coordination with the Anesthesiologist, so that there is no interference with the anticipated anesthesia.
4. Recovery time is slightly quicker with the microscurgery, but actually either surgery method usually recovers relatively quickly.
5. The bandage will leave the penis free for urination.
6. Since the epididymal cysts arise off the epididymis, there is some dissection needed in all cases, not just for small ones.
7. The odds of stitches coming loose prematurely is very low.
8. The surgeons at our facility instruct patient to remove the bandage at 24 hours and allow cleaning of the wound. If the bandage needs to be continued, then you will be instructed to replace the bandage after the wound is clean and dry.
9. A drainage tube is generally not needed, particularly for small cysts and varicoceles.
10. It may be an alternative to drain the cysts with a needle and syringe. This will not get rid of the cyst, but may be able to relieve enough pressure that they are no longer causing any symptoms. The doctor may also consider injecting a medicine that may induce scarring of the cyst, to try to prevent recurrence. Injection may not be well tolerated, but would be more of a consideration in someone that is trying to avoid surgery. Of course, if the cysts are not causing symptoms, it would be an option to do nothing except monitor the cyst and varicocele over time.