Endoscopic versus open hydrocelectomy for the treatment of adult hydroceles: a randomized controlled clinical trial

To compare outcomes of endoscopic treatment of hydrocele with conventional open hydrocelectomy regarding complications and patient satisfaction.

Patients with clinically significant hydroceles were prospectively enrolled into two treatment groups. Groups 1 and 2 consisted of patients who underwent endoscopic (n = 27) and open surgical treatments (n = 27), respectively. Outcome measures were perioperative and postoperative complications and recurrence rates.

Hydrocele recurred in the first two cases in Group 1 during the initial phase of the learning curve of the technique. No recurrence was encountered in Group 2. As a complication, moderate to severe edema occurred in 4 cases in the endoscopic group. In the open surgery group, significant edema and hematoma occurred in 8 and 2 cases, respectively. On the first and tenth postoperative days, endoscopic procedure was found more cosmetically acceptable and covered a more comfortable convalescence period when compared to open surgical group (P < 0.05). In Groups 1 and 2, 88 and 70% of the patients, respectively, declared that they would recommend this procedure to their friends (P < 0.05).

Endoscopic method is a viable option in the treatment of hydrocele. Outstanding feature of the endoscopic method is an earlier achievement of a better cosmetic outcome and a comfortable postoperative period when compared with the conventional treatment.