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New Indian Journal of Surgery

Volume  10, Issue 2, March-April 2019, Pages 175-181

 

Original Article

A Comparative Study of Different Surgical Procedures in the Management of Primary Vaginal Hydrocele
Omkar Mahendra Shirke1, Balaji Dhaigude2, S.V. Panchbhai3, Shahaji Chavan4
1Resident, 2Professor & HOU, 3Professor & HOU, 4Professor & HOD, Department of General Surgery, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, Dr. D.Y Patil Vidyapeeth, Pune, Maharashtra 411018, India.
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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10219.8

Abstract

 Introduction: A hydrocele is an accumulation of serous fluid in a body cavity. A hydrocele testis is the accumulation of fluids around a testicle. Vaginal hydrocele is the most common primary hydrocele. There are different operative and non-operative treatment for hydrocele and as many procedures are used for hydrocelectomy such as Jabouley’s Lord’s, Patch technique, Aspiration and sclerotherapy procedures. The common complications observed during the surgery of hydrocele are bleeding, injury to the cord structures and epididymis, torsion of the testis after a faulty positioning post operatively. Commonest among these is post-operative hematoma which is due to oozing from small vessels. Aims and Objectives: AIM - A comparative study of different surgical procedures in the management of primary vaginal hydrocele. Objectives: To study surgical management of hydrocele by different surgical procedures in following type of surgeries (Jaboulay’s Operation, Lord’s Plication and subtotal excision of sac). To assess postoperative complications associated with different surgical procedures. Material and Methods: A hospital based prospective study was conducted with 60 patients to assess the different surgical procedures in the management of primary vaginal hydrocele and postoperative complications associated with different surgical procedures. Observations & Results: The duration of hydrocele ranged from 2 months to 15 years. Majority of the patients (36.7%) had duration of 0-6 months while minimum number of patients (5%) had duration of 6-10 years. Hydrocele occurred more in right as compared to left side (53.3% vs. 26.7%). Bilateral hydrocele was seen in 12 (20%) patients. All patients (100%) presented with scrotal swelling. 12 (20%) patients had dragging type of pain while 8(13.3%) patients had mechanical discomfort due to scrotal swelling. Majority of the patients undergoing surgery (60%) were given spinal anaesthesia while 24 (40%) patients were operated under local anaesthesia. Jaboulay’s operation was performed on 37 (61.7%) patients of which 8 patients had bilateral hydrocele. Lord’s plication was performed on 11 (18.3%) patients of which 1 patient had bilateral hydrocele while Subtotal excision of sac was performed in 12 (20%) patients of which 3 patients had bilateral hydrocele. Majority of the complications were observed in patients that underwent Subtotal excision of sac and the least number of complications were observed in patients that underwent Jaboulay’s Operation. Conclusion: Considering the percentage of complications in different operative techniques, it is observed that there were least complications in Jaboulay’s Operation. So, Jaboulay’s Operation is best technique available in suitable cases for Jaboulay’s Operation.

Keywords: Vaginal hydrocele; testis; hematoma; Jaboulay’s operation; Lord’s placation; Subtotal excision of sac.


Corresponding Author : Balaji Dhaigude