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Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
[Surgical treatment of hydrocele with local anesthesia: 10-year experience]
A Blanco Espinosa1, I Olmo Cerezo, J A Merchán García
1Servicio de Urología, Hospital Comarcal Valle de los Pedroches, Pozoblanco, Córdoba, España.
Objective:
To review our experience with surgical management of hydrocele under local anesthesia.
Methods:
From January 1991 to March 2001, 76 patients with hydrocele (6 bilateral) were treated in our department. Patients were monitored in the OR (EKG, BP and pulseoxymetry); a peripheral line was inserted. Twenty minutes before the procedure, midazolam (5 mg), meperidine (50 mg) and atropine (0.5 mg) were administered i.m. for sedation. The spermatic cord and the area of the scrotal wall to be incised were injected with 2% mepivacaine (10-20 cc). Dissection and excision of the vaginalis sac was performed.
Results:
Anesthetic tolerance was very good in 71 patients (93%) and unsatisfactory in 5 (7%). The following complications were observed: scrotal hematoma (4 cases; 5%), infection (3 cases; 4%), bradycardia and hypotension (2 cases; 3%). Only 5 patients (7%) required hospitalization for more than 24 hours.
Conclusions:
Surgical management of hydrocele can be performed under local anesthesia, thereby avoiding the morbidity of more aggressive anesthetic techniques. This treatment procedure should be considered in the smaller departments with limited resources.

