From the Research
The treatment for an 18-year-old male with hydroceles is surgical intervention, specifically hydrocelectomy, which is the most effective method for preventing recurrence and minimizing complications, as supported by the most recent and highest quality study 1. The standard surgical procedure involves making a small incision in the scrotum, draining the fluid, and removing the hydrocele sac. This outpatient procedure is performed under general or local anesthesia and typically takes 30-45 minutes. Some key points to consider in the treatment of hydroceles include:
- Observation is recommended if the hydrocele is asymptomatic and not causing discomfort.
- Aspiration of the fluid without surgery is generally not recommended as the hydrocele often recurs, with a recurrence rate of 34.6% after sclerotherapy 2.
- Hydrocelectomy has a higher success rate and higher patient satisfaction compared to sclerotherapy, with a satisfaction rate of 95% versus 61.9% respectively 2.
- The use of sclerosing agents, such as sodium tetradecyl sulphate (STDS), has been shown to have a cure rate of 76% after a single injection and 94% after multiple treatments, with low side effect rates 1. Recovery involves rest for 1-2 days, scrotal support for 1-2 weeks, and avoiding strenuous activities for 2-4 weeks. Pain management includes over-the-counter medications like acetaminophen or ibuprofen (400-600mg every 6-8 hours as needed). It is essential to note that hydroceles form when fluid accumulates between the layers of the tunica vaginalis surrounding the testicle, and surgical correction provides a definitive solution by removing the tissue that produces the fluid. Minimally invasive hydrocelectomy through a 2-cm incision has been shown to be an effective and safe procedure, with no recurrence and minimal complications 3. In summary, hydrocelectomy is the recommended treatment for an 18-year-old male with hydroceles, due to its high success rate, low recurrence rate, and high patient satisfaction.