Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Individualized minimally invasive treatment for adult testicular hydrocele: A pilot study
Le Lin, Huai-Shan Hong, Yun-Liang Gao, Jin-Rui Yang, Tao Li, Qing-Guo Zhu, Lie-Fu Ye, Yong-Bao Wei
Le Lin, Huai-Shan Hong, Tao Li, Qing-Guo Zhu, Lie-Fu Ye, Yong-Bao Wei, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian Province, China
Le Lin, Huai-Shan Hong, Tao Li, Qing-Guo Zhu, Lie-Fu Ye, Yong-Bao Wei, Department of Urology, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Yun-Liang Gao, Jin-Rui Yang, Department of Urology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
Author contributions: All authors helped to perform the research; Lin L and Hong HS drafted the manuscript; Gao YL and Ye LF reviewed the published articles and analyzed the data; Yang JR and Zhu QG performed the surgeries and participated in the case diagnosis and follow-up; Li T and Wei YB sponsored the study; all authors read and approved the final manuscript.
Supported by the Joint Funds for Innovation of Science and Technology, Fujian Province, No. 2017Y9064.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Fujian Provincial Hospital (No. K2018-12-010).
Informed consent statement: Written informed consent was obtained from all of the patients.
Conflict-of-interest statement: The authors have stated that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yong-Bao Wei, MD, Attending Doctor, Shengli Clinical Medical College of Fujian Medical University; Department of Urology, Fujian Provincial Hospital, No. 134, Dong Street, Fuzhou 350001, Fujian Province, China. weiyb2008@163.com
Telephone: +86-591-88217270 Fax: +86-591-88217270
Received: January 14, 2019
Peer-review started: January 15, 2019
First decision: January 26, 2019
Revised: February 2, 2019
Accepted: February 26, 2019
Article in press: February 26, 2019
Published online: March 26, 2019
ARTICLE HIGHLIGHTS
Research background
Hydrocelectomy is the gold standard for the treatment of hydrocele, but it often causes complications, including hematoma, infection, persistent swelling, hydrocele recurrence, and chronic pain. Several methods for minimally invasive treatment of hydrocele have been introduced, but they all have limitations. We retrospectively analyzed the records of 52 adult patients with idiopathic testicular hydrocele who underwent a new minimally invasive technique for individualized treatment of testicular hydrocele from September 2010 to January 2018.
Research motivation
To investigate the feasibility of this individualized treatment.
Research objectives
To present a new method of treatment of adult patients with idiopathic testicular hydrocele.
Research methods
The study subjects were 52 adult patients with idiopathic testicular hydrocele who underwent the minimally invasive procedure. We designed the resection of the sheath of the tunica vaginalis according to the maximum diameter (d) of the hydrocele by ultrasound; the maximum diameter of the removal sheath was estimated as πd/2. A 2-cm incision in the anterior wall of the scrotum was made, through which the sheath of the tunica vaginalis was pulled out and peeled away from the underlying scrotal contents. After the sheath was dissected to the predetermined extent, it was removed. The intraoperative findings and postoperative complications were analyzed.
Research results
All patients were successfully treated within a median operation time of 18 minutes. The median maximum diameter of the effusion on ultrasound was 3.5 cm, and the median maximum diameter of the resected sheath was 5.5 cm. Complications occurred in four (7.7%) patients: two (3.8%) cases of mild scrotal edema, one (1.9%) case of scrotal hematoma, and one (1.9%) case of wound infection. All of the complications were grade I-II. Recurrent hydrocele, chronic scrotal pain, and testicular atrophy were not observed during a median follow-up period of 12 mo.
Research conclusions
We report a new technique for the individualized treatment of testicular hydrocele, which is quantitative and minimally invasive and yields good outcomes.
Research perspectives
We provide a promising application of this individualized treatment for hydrocele; more clinical studies may be needed to verify its safety and efficacy.
