Microscopic single-tubule technique for spermatocelectomy in cases of spermatocele: a rarely used surgical method and ıts outcomes.

[PURPOSE] This study aims to promote the microscopic single-tubule spermatocelectomy technique. The technique significantly reduces the risks of epididymal injury, infertility, and spermatocele recurrence rates.

[METHODS] From January 2015 to June 2024, male patients aged between 18 and 50 years who underwent microscopic single-tubule spermatocelectomy with the intent to preserve fertility were included in this study. Data on patient age, preoperative and postoperative sperm analysis results, and complication rates were recorded. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) v26 for Windows.

[RESULTS] The mean age of the patients was 40.93 ± 6.20 years. The average size of the spermatoceles was 6.44 ± 2 cm. The mean duration of the operation was 45.44 ± 8.82 min. While there was no statistically significant difference in sperm count and volume averages between preoperative and postoperative measurements, a statistically significant was observed in sperm motility. In terms of complications, 3.7% of the patients (n = 1) developed an infection. No epididymal bleeding or iatrogenic tubule opening was detected under the microscope. None of the patients experienced bleeding, spermatocele recurrence, testicular atrophy, or sperm granuloma. Pathological evaluations revealed no epididymal tissue in any of the cases.

[CONCLUSION] Microscopic single-tubule spermatocelectomy reduces the risk of epididymal injury and testicular atrophy, and it is associated with low complication rates. Particularly in male patients desiring fertility preservation, microscopic single-tubule spermatocelectomy offers high success rates and low complication rates and should be considered the preferred surgical technique.