From the Research
Treatment for hydrocele should prioritize hydrocelectomy as the standard procedure, given its high success rate and low recurrence rate, as supported by the most recent and highest quality studies 1, 2. When considering treatment options for hydrocele, it's essential to weigh the benefits and risks of each approach.
- Asymptomatic or small hydroceles may resolve spontaneously, particularly in infants, and watchful waiting is often recommended.
- Surgical repair, specifically hydrocelectomy, is the definitive approach for symptomatic hydroceles, involving the removal or reattachment of the tunica vaginalis to prevent recurrence.
- Alternative procedures, such as needle aspiration with sclerotherapy, have higher recurrence rates than surgery but may be considered for patients who prefer a less invasive approach or have contraindications for surgery 3, 2.
- The Lord's procedure, a less invasive surgical option, involves plication of the sac without excision and may be considered for select patients.
- Post-procedure care typically includes managing scrotal swelling and discomfort with over-the-counter pain medications like acetaminophen or ibuprofen.
- Treatment is recommended when hydroceles cause pain, discomfort, or cosmetic concerns, as they can sometimes indicate underlying testicular pathology 1.
- A study from 2022 found that aspiration and sclerotherapy with doxycycline is a safe and effective treatment alternative for hydrocele, with a success rate of 77% and minimal complications 2.
- However, another study from 2009 noted that while aspiration-sclerotherapy had fewer complications and was less expensive, it had a lower success rate and less patient satisfaction compared to hydrocelectomy 4.
- Ultimately, the choice of treatment should be individualized based on patient preferences, medical history, and the severity of symptoms, with hydrocelectomy remaining the gold standard for definitive treatment 1, 2.