Sclerotherapy of hydroceles and spermatoceles with alcohol: results and effects on the semen analysis

Abstract

Purpose:To evaluate the success rates of sclerotherapy of the tunica vaginalis with alcohol for the treatment of hydroceles and/or spermatoceles, as well as, evaluation of pain, formation of hematomas, infection and its effects in spermatogenesis . Materials and Methods: A total of 69 patients, with offsprings and diagnosis of hydrocele and/or spermatocele, were treated during the period from April 2003 to June 2007. Semen analysis was obtained from patients who were able to provide us with samples. The sclerotherapy with alcohol at 99.5% was undertaken as outpatient procedure. Results: The average volume drained pre-sclerotherapy was 279.82 mL (27 to 1145). The median follow-up was 43 months (9 to 80). A total of 114 procedures were performed on 84 units, with an average of 1.35 procedures / unit and an overall success rate of 97.62%. Of the 69 patients, 7 (10.14%) reported minor pain immediately after the procedure, 3 (4.35%) moderate pain and 2 (2.89%) intense pain. Post-Sclerotherapy spermograms revealed reduction of the parameters regarding: concentration, motility and morphology up to 6 months post procedure , with return to normal parameters 12th months after procedure. Conclusions: Sclerotherapy of hydroceles and spermatoceles with 99.5% alcohol is an efficient procedure that can be perormed without difficulties, cost-effectiveness, with few side effects and which may be performed in patients who wish fertility.

Aspiration and sclerotherapy of hydroceles and spermatoceles/epididymal cysts with 100% alcohol

“…This remained high even with repeat procedures for recurrence (100%). Shan et al . found only 3% reported high intensity pain with alcohol as a sclerosant.…”

“…The addition of sclerotherapy triggers necrosis of the cyst epithelium, which leads to coaptation of the walls. Multiple sclerosing substances have been described, including talc, phenol, polidocanol, doxycycline, tetracycline, sodium tetradecyl sulphate and a single study using alcohol …”

The use of TPA in combination with alcohol in the treatment of the recurrent complex hydrocele

“…Each agent reports a cure rate ranging from 85% to 97%, with complication rates of up to 50%. [8][9][10][11][12] Alcohol is a sclerosing agent that has a chemical irritant effect on the contacting tissue. The necrosis produced by alcohol injection is secondary to cellular dehydration, cell membrane lysis, and protein denaturation.…”

Sclerotherapy of hydrocele with ethanol (a literature review)

“…Из 69 пациентов 7 (10,14 %) сразу сооб-щили о легкой боли после процедуры, 3 -об умерен-ной боли (4,35 %), а 2 -о сильной (2,89 %). После склеротерапии до 6 мес на спермограммах были сни-жены параметры концентрации, подвижности и мор-фологии, возврат к нормальным параметрам состоялся через 12 мес после процедуры [26]. Авторы заключали, что склеротерапия гидроцеле и сперматоцеле с 99,5 % спиртом является эффективной процедурой, которая может быть выполнена без трудностей, с экономической эффективностью и немногими побочными эффектами, особенно для пациентов, желающих иметь детей.…”