Ultrasound-based Evaluation of Postoperative Scrotal Swelling following Jaboulay's Procedure: A Prospective...

Postoperative scrotal swelling is a common occurrence following hydrocelectomy and may raise concern regarding complications, such as hematoma, infection, or recurrence. Differentiating physiological postoperative changes from pathological findings based on clinical examination alone can be challenging in the early postoperative period. Ultrasonography provides an objective and noninvasive method for postoperative evaluation; however, prospective data on serial ultrasound-based assessment following Jaboulay's procedure remain limited.

This prospective observational study included 75 adult patients with vaginal hydrocele who underwent Jaboulay's procedure at a tertiary care teaching hospital over 18 months. All patients underwent standardized ultrasonographic evaluation on postoperative day 2 (POD 2), POD 10, and at 2 months after surgery. Parameters assessed included scrotal wall thickness and epididymal head, body, and tail dimensions. Continuous variables were expressed as mean ± standard deviation and analyzed using repeated measures analysis of variance, whereas categorical variables were compared using the McNemar test.

The mean age of patients was 52.4 ± 16.8 years. On POD 2, 48.0% of patients demonstrated moderate swelling, and 36.0% had mild swelling. By POD 10, a significant reduction in swelling was observed, with 60.0% of patients showing minimal swelling and 40.0% demonstrating complete resolution ( P < 0.001). The mean scrotal wall thickness decreased significantly from 6.6 ± 1.9 mm on POD 2 to 4.6 ± 1.3 mm at 2 months ( P < 0.001). Significant reductions were also observed in epididymal dimensions across follow-up intervals ( P < 0.001). Postoperative hematoma occurred in 5.3% of patients and was managed conservatively.

Postoperative scrotal swelling following Jaboulay's procedure is predominantly physiological and resolves progressively over time. Serial ultrasonography plays an important role in differentiating normal postoperative changes from complications.