What are the indications for scrotal approach to hydrocele treatment?

Updated: Oct 28, 2020
  • Author: Jacob C Parke, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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The scrotal approach, with excision or eversion and suturing of the tunica vaginalis, is recommended for chronic noncommunicating hydroceles. This approach should be avoided upon any suspicion for underlying malignancy.

In contrast, Alp et al report that the scrotal approach is an effective alternative for the treatment of communicating hydrocele in pediatric patients. In their study of 43 boys (46 testicular units) treated with the classic inguinal approach and 27 boys (30 testicular units) treated with a scrotal approach, operative time was significantly lower in the scrotal group (P <  0.0001), the early minor complication rate did not differ between the two groups, no major complications noted, and none of the patients had hydrocele recurrence after a mean follow-up of 6 months. [16]

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