Lawrence Tsai1, Preston A Milburn2, Charles L Cecil3, Patrick S Lowry2, Michael R Hermans4. 1. Baylor Scott and White Health, Department of Surgery, Division of Urology, Temple TX. Electronic address: Lawrence.Tsai@BSWHealth.org. 2. Baylor Scott and White Health, Department of Surgery, Division of Urology, Temple TX. 3. Hendrick Health System, Department of Urology, Abilene, TX. 4. Central Texas Veterans Healthcare System, Temple, TX.
Abstract
OBJECTIVE: To determine if recurrence rates and complication rates differ between 3 different techniques for treatment of idiopathic hydrocele: Jaboulay's bottleneck, hydrocelectomy, or Lord's technique. METHODS: All surgeries for idiopathic hydrocele in the health system were reviewed from 2000 to 2011. Recurrence rate, complication rate, and other surgical data were collected and analyzed. RESULTS: The 276 surgeries were performed using the following techniques: 70 (26%) Jaboulay's repair, 127 (46%) hydrocelectomy, and 79 (28%) Lord's repair. 18 (6%) hydrocele procedures required repeat surgery for recurrence, and there were no statistical differences between all techniques. Complications occurred in 32 (11.6%) of 276 surgeries and included hematoma, postoperative testalgia, and infection. Lord's repair had a significantly lower overall complication rate and rate of hematoma (P = .0016, P = .023). There was no difference between the groups with regard to infection or pain. The median volume of fluid removed with the Jaboulay's approach was 200 mL, and the volumes were 270 mL for each of the hydrocelectomy and Lord's repair, respectively. The largest volume hydrocele treated was 2.4 L and was performed with Lord's repair. CONCLUSION: Overall recurrence rate after open hydrocele surgery was 6%, and did not differ between the surgical techniques analyzed. The overall rate of complications and the rate of postoperative hematoma were lowest with Lord's repair. This data reaffirms the existing literature on hydrocele repair technique, and suggests that Lord's repair is an efficacious and safe choice in treating hydroceles.
OBJECTIVE: To determine if recurrence rates and complication rates differ between 3 different techniques for treatment of idiopathic hydrocele: Jaboulay's bottleneck, hydrocelectomy, or Lord's technique. METHODS: All surgeries for idiopathic hydrocele in the health system were reviewed from 2000 to 2011. Recurrence rate, complication rate, and other surgical data were collected and analyzed. RESULTS: The 276 surgeries were performed using the following techniques: 70 (26%) Jaboulay's repair, 127 (46%) hydrocelectomy, and 79 (28%) Lord's repair. 18 (6%) hydrocele procedures required repeat surgery for recurrence, and there were no statistical differences between all techniques. Complications occurred in 32 (11.6%) of 276 surgeries and included hematoma, postoperative testalgia, and infection. Lord's repair had a significantly lower overall complication rate and rate of hematoma (P = .0016, P = .023). There was no difference between the groups with regard to infection or pain. The median volume of fluid removed with the Jaboulay's approach was 200 mL, and the volumes were 270 mL for each of the hydrocelectomy and Lord's repair, respectively. The largest volume hydrocele treated was 2.4 L and was performed with Lord's repair. CONCLUSION: Overall recurrence rate after open hydrocele surgery was 6%, and did not differ between the surgical techniques analyzed. The overall rate of complications and the rate of postoperative hematoma were lowest with Lord's repair. This data reaffirms the existing literature on hydrocele repair technique, and suggests that Lord's repair is an efficacious and safe choice in treating hydroceles.