From the Guidelines
Medications are not the primary treatment for hydroceles or varicoceles, and surgical correction or embolization procedures are typically recommended. For hydroceles, which are fluid collections around the testicle, treatment usually involves surgical repair (hydrocelectomy) if the condition causes discomfort or is cosmetically concerning [ 1 ]. Similarly, for varicoceles, which are enlarged veins in the scrotum, the standard treatment is surgical correction through varicocelectomy or embolization procedures rather than medication [ 1 ].
Some key points to consider:
- There are no FDA-approved medications specifically for hydroceles.
- Varicoceles are most often treated in cases of orchialgia, infertility, or reduced testicular size in adolescents [ 1 ].
- Endovascular therapy embolizes the affected spermatic vein using coils or sclerosants, and studies have shown that gonadal vein embolization is effective for relieving orchialgia [ 1 ].
- While some physicians might prescribe non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for temporary pain relief, these medications don't address the underlying anatomical issue [ 1 ].
In cases where varicoceles cause fertility concerns, treatment focuses on surgical correction rather than medication [ 1 ]. The reason medications aren't effective for these conditions is that they're structural problems - a hydrocele involves fluid accumulation in a sac, while a varicocele involves dilated veins with compromised valves, neither of which can be corrected pharmacologically. If you're experiencing discomfort from either condition, consult a urologist to discuss appropriate treatment options.
From the Research
Medications for Hydroceles and Varicoceles
There are various treatment options available for hydroceles and varicoceles, including medications and surgical procedures.
- For hydroceles, a study published in 1988 2 found that injection of a tetracycline solution was effective in treating hydrocele testis, with a cure rate of 81.8%.
- Another study published in 1998 3 investigated the use of fibrin glue application therapy in testicular hydrocele, but found it to be not sufficiently effective.
- For varicoceles, a study published in 2020 4 reported a case of robotic resection of the gonadal vein for treatment of chronic abdominal pain after varicocele embolization.
- A review of the literature published in 2020 5 found that varicocele repair may increase serum testosterone level in men with varicoceles and testosterone deficiency, and that microsurgical varicocele repair could be preferred to provide the best improvement.
Treatment Options
The treatment options for hydroceles and varicoceles include:
- Injection of a tetracycline solution for hydroceles 2
- Fibrin glue application therapy for hydroceles 3
- Varicocele embolization for varicoceles 4
- Microsurgical varicocele repair for varicoceles 5
- Robotic resection of the gonadal vein for treatment of chronic abdominal pain after varicocele embolization 4
Effectiveness of Treatment
The effectiveness of these treatment options varies, with some studies reporting high success rates and others finding limited effectiveness.
- The study on tetracycline solution injection for hydroceles reported a cure rate of 81.8% 2
- The study on fibrin glue application therapy for hydroceles found it to be not sufficiently effective 3
- The review of the literature on varicocele repair found that it may increase serum testosterone level in men with varicoceles and testosterone deficiency 5