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Anna Krarup Keller1,2, Maiken Milly Howard1, Jørgen Bjerggaard Jensen1,3
1Department of Urology, Regional Hospital West Jutland, Holstebro, Denmark.
Insights
Surgical repair of hydrocele and spermatocele can lead to complications. Improved preoperative patient information by specialists significantly reduced complications and reoperations, despite initial awareness efforts.
Area of Science:
- Urology
- Surgical Outcomes
Background:
- Surgery is the gold standard for symptomatic hydrocele or spermatocele.
- Complications like bleeding and infection can necessitate reoperation, causing significant patient distress.
Purpose of the Study:
- To investigate complication rates and identify methods for reduction.
- To analyze the impact of preoperative patient information on surgical outcomes.
Main Methods:
- Retrospective review of patient records for hydrocele/spermatocele repairs (Dec 2017-Nov 2018).
- Audited results focusing on perioperative hemostasis and postoperative activity.
- Compared outcomes with a consecutive patient series from the following year.
Main Results:
- In the first year, 6/65 patients required reoperation; in the second year, 5/69 patients needed reoperation.
- No significant difference in complication rates between specialist and supervised junior urologists.
- Patients informed by specialists had significantly fewer complications than those informed by residents/interns (p=0.012).
Conclusions:
- Despite increased awareness, a high rate of unplanned patient contact and reoperation persists.
- Specialist-led preoperative patient education is crucial for reducing surgical complications.
Objective:
Gold standard treatment of symptomatic hydrocele or spermatocele is surgery. Despite a minor procedure, complications such as bleeding and infections leading to reoperations may be devastating for the patients. In autumn 2018, an accumulation of complications was seen in our department. The aim of this study was to investigate the rate and grade of complications and to identify potential means to reduce these.
Materials And Methods:
Patient records of all patients undergoing surgical repair of hydrocele or spermatocele from December 2017 to November 2018 were examined. Results were audited to identify potential causes of complications. The focus was on the perioperative hemostasis and postoperative activity restrictions. The outcome was compared to a consecutive patient series operated the following year.
Results:
Sixty-five men were operated on during the first period. Twenty-two patients contacted the department postoperatively due to swelling or pain, 19 patients were examined at the hospital and six patients were re-operated 1-9 times. The following year, 69 patients were operated on. Of these, 16 patients contacted the department postoperatively (p = 0.17), 13 patients were examined at the hospital, and five patients were re-operated (p = 0.68). There was the same complication rate in patients operated by specialist urologists or supervised younger doctors. However, patients preoperatively examined and informed by a specialized urologist had significantly fewer complications compared to those informed by urological residents and interns (p = 0.012).
Conclusion:
Despite the change in patient information and increased awareness of possible complications, a high proportion of patients still were in need of unplanned contact to the department and reoperation.
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