Minimal hydrocelectomy with the aid of scrotoscope: a ten-year experience

Since hydrocelectomy remains the choice of surgical treatment of hydrocele and standard surgical procedures may cause postoperative discomfort and complications, a new minimal surgery procedure is needed. The scrotoscope was used for the diagnosis and treatment of intrascrotal lesions. The aim of the study is to illustrate a new minimal hydrocelectomy with the aid of scrotoscope, in an effort to decrease complications.

Between 2002 and 2012, 65 patients underwent hydrocelectomy with the aid of a scrotoscope. Before carrying out hydrocelectomy, the scrotoscopy was first used to examine the intrascrotal contents to exclude any pathological lesions. After determining the condition of testis, epididymis and spermatic cord and excluding any other secondary causes of hydrocele, a 2.0 cm scrotal incision was performed. The parietal tunica vaginalis was then grasped out of scrotum, and the mobilized tunica was excised. The scrotoscopy was then performed again to inspect the intrascrotal contents.

Mean operative time was 35.4 minutes. No major complications occurred during the post-operative follow-up period. Of these 65 patients, 61 underwent scrotoscopy and minimal hydrocelectomy, two patients underwent open hydrocelectomy because thickening of hydrocele wall was identified; two patients with acute inflammation only underwent scrotoscopy. Pathological changes were observed among eight patients. All patients were satisfied with the outcomes.

Minimal hydrocelectomy shows commendable results and fewer complications. The combination of minimal hydrocelectomy and scrotoscopy seems to be an encouraging technique. This novel surgical procedure proves to be a viable option for the diagnosis and treatment of hydrocele.