Comparison of aspiration-sclerotherapy with hydrocelectomy in the management of hydrocele: A prospective randomized study

BackgroundHydrocelectomy is practiced as the gold standard technique for the treatment of hydrocele worldwide. Aspiration and sclerotherapy is cheap, less invasive and safe compared to hydrocelectomy. However, the outcomes are inconsistent because of lack of uniformity in methods and sclerosing agents used.Materials and methodsThis was a randomized controlled study conducted in a university hospital for a period of one year. Sixty symptomatic adult males without fertility concern or coexisting scrotal pathology were enrolled. Aspiration and sclerotherapy and hydrocelectomy were performed in 30 each. Primary outcome measures: incidence of complications, loss of working days, cost involved, recurrence rate and patient's satisfaction. Patients were followed up till 6 months after the procedures.ResultsEight patients (26.7%) after hydrocelectomy developed fever which was significantly more (p < 0.05) than 2 patients (6.7%) following sclerotherapy. Four patients (14%) with hydrocelectomy had infection (p < 0.05). The incidence of pain and haematocele between the two groups were comparable. Nine patients (34.6%) after sclerotherapy developed recurrence at 3 months. All patients developed recurrence after repeat aspiration and sclerotherapy. The level of satisfaction was more in hydrocelectomy 19 (95%) versus 13 (61.9%) patients in sclerotherapy (p < 0.05). The cost involved was fivefold and the loss of working days sevenfold in hydrocelectomy (p < 0.01) as compared to sclerotherapy.ConclusionAlthough aspiration and sclerotherapy had less complications, morbidity and was cheaper, it had lower success rate and less patient's satisfaction than hydrocelectomy.