Sonographic follow-up of ethanolamine oleate sclerotherapy for hydrocele

Sclerotherapy has gained increasing popularity during the last few years as a treatment for hydrocele. Little is known of the natural course of intrascrotal changes, however, nor of their timetable after therapy. In the present trial scrotal ultrasonography was performed before the sclerotherapy and during the follow-up examination in the case of 70 symptomatic consecutive outpatients ranging in age from 19 to 85 years (mean, 58 years) with 71 hydroceles treated by ethanolamine oleate sclerotherapy. Posttreatment sonographic findings typically included heterogeneously echogenic extratesticular masses, cystic areas with peritesticular hyperechoic lines, and a thickened scrotal wall. All the lesions showed improvement. Sonography proved to be useful for differentiating hydroceles from spermatoceles and for evaluating the need for a renewed treatment during follow-up. Ethanolamine oleate was effective as a sclerosant, as 86% of cases were cured or significantly improved. Complications were mild and uncommon, and no intratesticular or epididymal changes were observed. Ethanolamine oleate sclerotherapy can be recommended as a treatment of choice for hydrocele.