Treatment of Hydrocele Testis with Aspiration and Sclerotherapy

Abstract

Introduction and Objective: Acquired hydrocele testis is a common cause of increase scrotal size in the adult male. In this study our aims is to demonstrate that Hydrocele aspiration sclerotherapy (HAS) with doxycycline is an effective and safe nonsurgical treatment option for the nonseptated hydrocele correction. Material and Methods: HAS was performed in an outpatient office setting in all patients in this study. Before undergoing HAS all patients were evaluated with a history, a thorough genital examination, and scrotal ultrasound to determine the nature of hydrocele. Men who presented with a nonseptated hydrocele and were interested in nonsurgical correction were eligible for HAS. Exclusion criteria were presentation with a multiseptated hydrocele, a recidivant hydrocele, spermatocele, infection or hernia. Results: There were 18 patients with mean age of 51.3 years who presented with nonseptated hydrocele testis between 2008-2013. Overall mean follow-up was 22.2 months. Of these hydroceles 83.3% (n=15) were successfully treated with a single HAS procedure. In the group reporting success 13 patients presented with unilateral hydrocele and 2 presented with a bilateral hydrocele. Mean, median and range of fluid aspirated from successful treatment group were 195cc (SD 115.3) and 100 to 500 cc, respectively. Of those patients in whom HAS failed,one had hydrocele successfully with a second HAS treatment,2 did not have success with a second HAS and underwent hydrocelectomy. Conclusion: HAS appears to be a safe quick, far less costly and reasonably effective in-office procedure for the treatment of nonseptated single hydroceles. Our findings demonstrate that success rate with HAS are similar to those with surgical management while avoiding many of the complications and expenses associated with surgery. For patients in whom HAS failes, surgical hydrocelectomy remains a viable treatment options.