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Jaboulay's versus harmonic scalpel hydrocelectomy: prospective randomized controlled study.

Dileep Singh Thakur1, Mansi Saraf1, Dinesh Kateha1

  • 1Department of General Surgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India.

International Urology and Nephrology
|September 1, 2023
PubMed
Summary

Harmonic scalpel sac excision for hydroceles offers better cosmetic results and less scrotal edema than the Jaboulay's procedure. This technique improves patient satisfaction by reducing postoperative swelling and mass sensation.

Keywords:
Harmonic scalpelHydrocelectomyJaboulay’s procedureScrotal edema

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Area of Science:

  • Urology
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Surgical management of vaginal hydroceles aims to prevent recurrence and improve cosmesis.
  • The Jaboulay's procedure is a common technique, but sac eversion can cause postoperative edema and discomfort, especially in large hydroceles.
  • Sac excision may offer superior outcomes by removing excess tissue.

Purpose of the Study:

  • To compare the outcomes of harmonic scalpel sac excision versus Jaboulay's procedure for adult hydroceles.
  • To evaluate differences in scrotal edema, hematoma formation, and cosmetic appearance.

Main Methods:

  • A randomized study involving 72 adult patients with vaginal hydroceles.
  • Patients were assigned to either harmonic scalpel sac excision or Jaboulay's procedure.
  • Postoperative data on complications and outcomes were collected, with cosmetic satisfaction assessed at 3 months.

Main Results:

  • The Jaboulay's procedure group showed slightly higher, though not statistically significant, rates of postoperative edema and scrotal mass sensation.
  • Seroma and wound infection rates were comparable between both surgical groups.
  • The harmonic scalpel sac excision group reported significantly better patient satisfaction with the cosmetic outcome.

Conclusions:

  • Hydrocelectomy utilizing harmonic scalpel sac excision leads to reduced postoperative edema.
  • This technique improves patient satisfaction regarding cosmetic results compared to the traditional Jaboulay's procedure for adult hydroceles.