Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India

Abstract

Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.

Study on Clinical Profile and Surgical Management of Cases of Primary Vaginal Hydrocele

“…Bilateral hydrocele was seen in 18.33%. [10] Hydrocele was predominant on right side in the study done by NagaMuneiah et al also. [8] Jaboulay procedure was done in 67.9% and Lord's procedure in 32.1%.…”

“…Maximum number of cases had duration of 6 months or less while minimum number of cases had duration between 6 and 10 years. [10] Right side was involved in 42.3% cases, left side in 37.2% and it was bilateral in 20.5%. In the study done by Kumar et al, swelling in right scrotum was seen in 53% cases, compared to 26% patients with the left scrotal swelling and bilateral scrotal swellings in 21% cases.…”

“…[9] Ahmed et al also found that the youngest patient was 16 years old while the oldest patient was 75 years of age with maximum number of cases seen in 20 -29 years age group followed by that in 30 -39 year age group while minimum number of cases were seen in 70 -79 years age group. [10] In most of the patients, the duration of scrotal swelling was less than one year. NagaMuneiah et al found that 41.6% patients had the duration of scrotal swelling of less than one year.…”

“…Partial/subtotal excision and eversion of sac was done for bigger hydroceles with thick sac. [9] Jaboulay repair was performed in 80% patients and Lord's plication was performed in 20% patients by Ahmed et al [10] Post-operative pain was seen in 35.9%, scrotal edema in 23.1%, hematoma in 7.7% and surgical site infection in 3.8%. Kumar Haematoma was observed in 15% of the cases and it was seen following Jabouley's and subtotal excision of sac, whereas no haematoma was observed in Lord's plication and herniotomies.…”

“…[9] Ahmed et al found that post-operative pain was more in bilateral hydrocele while wound infection and skin oedema was more common in unilateral hydrocele, possibly due to larger size of unilateral hydrocele. [10]…”