Aspiration and Sclerotherapy: A Minimally Invasive Treatment for Hydroceles and Spermatoceles.

Abstract

OBJECTIVE:

To describe our contemporary experience with aspiration and sclerotherapy (AS) as a non-surgical alternative for patients with symptomatic hydrocele and spermatocele who prefer non-surgical treatment.

MATERIALS AND METHODS:

Patients were identified by billing diagnosis code for hydrocele or spermatocele from 2015 to 2019. Patients underwent AS with doxycycline (200-400 mg). Physical examination, ultrasound and aspirate microscopy were used to differentiate hydrocele from spermatocele. Baseline and follow-up data were recorded.

RESULTS:

In total, 65 patients underwent AS, 54/65 (83%) for hydrocele and 11/65 (17%) for spermatocele with mean aspirate volumes 307 mL (SD 238 mL) and 138 mL (SD 112 mL), respectively. Follow-up data was available for 38/54 (70%) hydroceles and 8/11 (73%) spermatoceles with median follow-up 28 (IQR 23-41) and 22 (IQR 18.5-30.5) months respectively. Relief of patient reported bother associated with scrotal size occurred in 29/38 (77%) hydroceles and 8/9 (89%) spermatoceles. 2/54 (4%) hydrocele patients developed hematoma managed with in-office aspiration. Immediate post-procedural pain occurred in 2/56 (4%) hydroceles and 2/10 (20%) spermatocele. Post-procedural pain requiring more than 5 tablets of hydrocodone/acetaminophen 5mg/325mg occurred in 2/57 (3%) hydroceles and 2/10 (20%) spermatoceles. Surgical repair was ultimately pursued in 3/38 (8%) and 1/9 (11%) patients with persistent hydrocele and spermatocele respectively.

CONCLUSION:

AS is a safe and effective treatment alternative for hydrocele and spermatocele for patients wishing to avoid surgery.

• Authors: Scott Brockman, Daniel Roadman, Petar Bajic, Laurence A Levine
• Journal: Urology (Urology) Vol. 164 Pg. 273-277 (06 2022) ISSN: 1527-9995 [Electronic] United States
• PMID: 34968574 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Topics

• Humans
• Male
• Pain, Procedural
• Sclerotherapy
• Spermatocele (complications, therapy)
• Testicular Hydrocele (diagnosis, therapy)
• Treatment Outcome