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[Randomised comparison of different exit strategies in hydrocele resection]
Simon Filmar1, Andreas Gross1, Christopher Netsch1
1Urologie, Asklepios Klinik Barmbek, Hamburg, Germany.
Insights
Surgical resection of adult hydroceles can lead to complications. This study found that using no drain or a Cuti-Med Sorbact drain reduced postoperative complications compared to Easy-Flow drains.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Adult hydrocele, a common scrotal enlargement, affects approximately 60/100,000 men over 18.
- Surgical resection is the standard treatment for symptomatic hydroceles, but it carries a risk of postoperative complications.
- Current hydrocele treatment lacks standardized guidelines, relying heavily on clinical experience.
Purpose of the Study:
- To investigate the impact of different drainage methods on postoperative complications following hydrocele resection.
- To compare the efficacy of Easy-Flow drainage, Cuti-Med Sorbact drainage, and no drainage in hydrocele surgery.
Main Methods:
- A prospective randomized study involving 60 patients undergoing hydrocele resection.
- Patients were allocated to three groups: Easy-Flow drainage, Cuti-Med Sorbact drainage, or no drainage.
- Complications assessed included hematoma, swelling, bleeding, infection, epididymal injury, and need for revision surgery.
Main Results:
- Overall complication rate was 31.6% (19/60 patients).
- The no-drainage group had the lowest complication rate (15%), followed by Cuti-Med Sorbact (30%), and Easy-Flow (50%).
- Hematoma with swelling was the most frequent complication (20%), and epididymal injuries occurred in 10% of cases. Easy-Flow drainage was associated with significantly more complications (p<0.018).
Conclusions:
- Hydrocele resection is a procedure with a notable risk of complications.
- Drainage insertion, particularly Easy-Flow, is associated with an increased risk of postoperative complications.
- Cuti-Med Sorbact drainage may be a safer option if wound drainage is deemed necessary during surgery.
Introduction:
Adult hydrocele is a benign enlargement of the scrotum seen in approximately 60/100,000 men >18 years of age. Surgical resection of the hydrocele has been established as the gold standard for the treatment of symptomatic hydroceles. Postoperative complications are common with this surgery. Due to the lack of guidelines for the therapy of hydrocele, treatment is based primarily on clinical experience. The aim of the study was to conduct a randomised study on the influence of drains on complications in hydrocele resection according to von Bergmann.
Material And Methods:
A total of 60 patients were prospectively randomised into three groups. The groups each received an Easy-Flow drainage, a Cuti-Med Sorbact drainage, or no drainage. Haematoma and swelling, postoperative bleeding, infection, epididymal injury and revision surgery were clinically diagnosed as complications.
Results:
A complication was observed in 31.6% (n=19/60) of all patients. The complication rate was 50% (n=10) for the easy-flow drainage, 30% (n=6) for the Cuti-Med-Sorbact and 15% (n=3) for the group without drainage. Overall, a haematoma with swelling was observed most frequently, in 20% (n=12) of the cases. Revision surgery was required in 5% (n=3) of cases. Epididymal injuries were found histologically in 10% (n=6). Comparing the collective with the Easy-Flow drainage with the collective without drainage, the occurrence of complications was observed significantly more frequently in the drainage group (p<0.018). A statistically significant correlation regarding complications between the group of Cuti-Med-Sorbact and no drainage could not be shown (p<0.25).
Conclusions:
Hydrocele resection is a complicated procedure. Based on the data presented here, the insertion of a drain is associated with an increased risk of postoperative complications. If the decision to insert a wound drainage is made intraoperatively, the Cuti-Med-Sorbact drainage appears to be associated with fewer complications.
