[A comparative evaluation of surgical methods for treating hydrocele]

The authors analysed the results of the surgical treatment of 167 patients with hydrocele who were operated on with the use of Winkelmann's or Bergmann's technique (group I), the same but modified by Grebenshchikov-Shevtsov's (group II), and Lord's method (group III). Sclerotherapy was employed in the group IV patients. A high percentage of complications was associated with Winkelmann and Bergmann's techniques (scrotal edema, hematoma, wound purulence) when the hydropic sac was isolated from the adjacent tissues. Postsurgical staying-in-bed time for those operated on with Winkelmann's and Bergmann's technique was mean 8.6 +/- 1.2 days and 9.4 +/- 1.3 days, respectively. When the same surgery was performed according to the Grebenshchikov-Shevtsov's modification a mean staying-in-bed time reduced to 7.2 +/- 0.9 days due to a lower incidence of postsurgical complications. Analysis of 42 surgeries performed with the Lord's method which avoided the isolation of the hydropic sac from the adjacent tissues demonstrated its efficacy and simplicity. No hematomas, suppurations or relapses were documented. The staying-in-bed time was 3.4 +/- 0.6 days. The pronounced changes in tunica propria and the multilocular character of hydrocele were the contradictions to this pattern of the treatment. In case the performance of the surgery was impossible, sclerotherapy with administration of 2-10 ml of 2.5 per cent of tetracycline solution was performed for the sclerosing and antibacterial effect. A mean staying-in-bed time was 2.1 +/- 0.9 days. Seven out of 8 patients recovered after 1-3 sessions of sclerotherapy.