Results of fibrin glue application therapy in testicular hydrocele

Nine patients, mean age 55 years, with testicular hydroceles, were treated by aspiration and two-component fibrin glue injection. One patient was treated twice. The glue contains 70-110 mg fibrinogen and 500 IU human thrombin in 0.5- and 2-ml injections, respectively (Tisseel duo quick, Immune AB). The smaller glue volume was used in 4 cases and the larger volume in 6 cases. The average volume of hydrocele fluid was 77 (range 60-120) ml. Treatment caused no pain or discomfort other than puncture of the skin and no pain-relieving medication was required afterwards. In this series there were no infections but one conservatively treated hematoma. The hydrocele of that patient disappeared. Although the hydroceles recurred in 9 cases during the mean follow-up of 3.5 months, in 2 patients the hydroceles were clinically smaller than the original one and symptoms were milder subjectively. Our findings suggest that fibrin-adhesive glue is not sufficiently effective in treatment of testicular hydroceles.