Comparison of outcomes and costs of surgery versus sclerotherapy to treat hydrocele

Abstract

Objective: To evaluate the outcomes and costs associated with surgery versus sclerotherapy as treatment of hydroceles. Methods: A total of 53 men consecutively treated for hydrocele at our organization, between December 2015 and June 2019, were retrospectively analyzed (39 with Jaboulay technique and 14 with sclerotherapy). All charts were reviewed, assessing clinical data, ultrasound findings, surgical data, and post-procedure outcomes. The hospital finance department calculated the cost of outpatient evaluation, complementary tests, supplies, drugs, and professionals' costs throughout all procedures. Results: The median age for both groups was similar (58 and 65 years old). Comorbidities were less frequent in the Surgery Group (20; 51%) than in the Sclerotherapy Group (14; 100%, p<0.05). The median length of hospital stay was 34.5±16.3 hours for the Surgery Group and 4 hours for the Sclerotherapy Group. The mean follow-up period was similar for both groups (85.4±114.8 days after surgery, and 60.9±80.1 days after sclerotherapy, p=0.467). No significant complications occurred in any patient. Success rates were 94.8% after surgery and 92.8% after sclerotherapy. The mean cost per patient was US$2,558.69 in the Surgery Group (Hydrocelectomy Group) and US$463.58 in the Sclerotherapy Group (p<0.0001). Costs directly related to in-hospital treatment procedures were significantly higher for surgery versus sclerotherapy

Injection Sclerotherapy in Encysted Hydrocele in Paediatric Population

“…WHO sample size calculator was used for determination of sample size with confidence level was 95%, population proportion was 92.8% (10) absolute precision was 8.2% then estimated sample size was 39.…”

“…A sclerosant is inserted during a radiological procedure to treat cystic lesions and lymphatic malformations 9 . Sclerotherapy is widely used to treat hydroceles in adults 10 , although it is seldom used in children because sclerosants are believed to erode the sac epithelium, preventing it from producing fluid. Rassam et al published a case study in which sclerotherapy was used to treat an abdomino-scrotal hydrocele in a 4-year-old boy with no complications 1 .…”

Comparison of sodium tetradecyl sulphate versus conventional hydrocelectomy for adult hydrocele aspiration.

“…Its usage is justified in adults, particularly in the elderly. 11 Although repetition may require in some patients to achieve complete eradication of hydrocele. Developing countries like India, Pakistan, Bangladesh studies reported sclerotherapy as a procedure of choice due to minimal cost of the procedure and fewer days requirement to recover as urologists reported the problems in developing countries is a financial burden not only on patients but health care setups as well.…”