Aspiration and Sclerotherapy for Hydrocele

Hydrocele, an abnormal accumulation of fluid between the parietal and visceral layers of the tunica vaginalis of the testis is the most frequently encountered mass of the scrotum. There are two types of treatment for hydrocele : Surgery and Sclerotherphy. Surgical treatment is generally considered the most effective. However, due to the frequent occurrence of complications of surgical procedure, sclerotheraphy may provide an alternative means of treatment. We here report the results of study using aspiration and subsequent injection of tetracycline as definitive treatment of testicular hydrocele. Four patients were treated after informed consent and followed for 5 to 10 months after sclerotheraphy. All treatment were given as an out-patient procedure. The aspiration were performed under local anesthesia, and the mean volume aspirated was 225ml(range : 150-350ml). Hereafter, 500mg of tetracycline diluted to a volume of 5ml in isotonic saline and 3ml in 2% lidocaine was injected. At 5 to 10 months follow up, all patients were cured-3 patients after one, and 1 patient after two injections. In one patient, the injection was immediately followed by scrotal pain which was relieved by spermatic cord block. The pain of the other patient were relieved by some oral analgesic medication. No infection or hematoma occured. In conclusion, aspiration and sclerotheraphy using tetracycline seems a favorable alternative to surgery for hydreceles. Tetracycline is both sclerosing, antibacterial and cheap. Further, the technique is simple, it carries a low morbidity and does not require hospitalization.