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Urology (Expert Forum)
Different procedures for hydrocelectomies ?
Answered by
Ash Tewari, MD, M.Ch. - Prostate Cancer, Robotic Prostatectomy, Urology, Oncology, Surgery
Lefrak Institute for Robotic Surgery and Prostate Cancer
New York - NY
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Different procedures for hydrocelectomies ?
by AndyK, Apr 18, 2007 12:00AM
Hi,
I have been diagnosed with a right hydrocele and am considering having a hydrocelectomy to remove it. I am not in any pain, but the swelling in my scrotum is making movement and wearing my clothes uncomfortable. I have visited two Urologists, both agree that a hydrocelectomy is the proper treatment given my age (42) and general health.
I asked both doctors about the details of how they would perform a hydrocelectomy and there appears to be a discrepancy in the details. Urologist A.'s description involves making an incision to remove the built up liquid, then somehow turning the SAC tissue inside out and re-attaching it. Urologist B.'s description involves removing the sac alltogether, except for that portion of the sac that is directly attached to my right testicle. When I asked Urologist B. about how I read online of the procedure to involve turning tissue inside out, he stated that some doctor's do that but he just removes them.
Here is my question: Is there really what appears to be variations of a hydrocelectomy, i.e. removal of the sac versus turning it inside out? If so, is one variation preferred over another? If the sac is completely removed and I were to be hit in my scrotum during any activity, i.e., sports, etc., would the resulting discomfort be acute due to the sac being removed?
Any help would be greatly appreciated.
I have been diagnosed with a right hydrocele and am considering having a hydrocelectomy to remove it. I am not in any pain, but the swelling in my scrotum is making movement and wearing my clothes uncomfortable. I have visited two Urologists, both agree that a hydrocelectomy is the proper treatment given my age (42) and general health.
I asked both doctors about the details of how they would perform a hydrocelectomy and there appears to be a discrepancy in the details. Urologist A.'s description involves making an incision to remove the built up liquid, then somehow turning the SAC tissue inside out and re-attaching it. Urologist B.'s description involves removing the sac alltogether, except for that portion of the sac that is directly attached to my right testicle. When I asked Urologist B. about how I read online of the procedure to involve turning tissue inside out, he stated that some doctor's do that but he just removes them.
Here is my question: Is there really what appears to be variations of a hydrocelectomy, i.e. removal of the sac versus turning it inside out? If so, is one variation preferred over another? If the sac is completely removed and I were to be hit in my scrotum during any activity, i.e., sports, etc., would the resulting discomfort be acute due to the sac being removed?
Any help would be greatly appreciated.
Doctor's Answer
by Ash Tewari, MD, M.Ch., Apr 20, 2007 12:00AM
, Apr 20, 2007 12:00AM
Dear AndyK,
Hydroceles fluid collections within the tunica vaginalis of the scrotum or along the spermatic cord. Pain or discomfort is a good indication that surgical treatment is warranted.
Both techniques you describe are effective treatments for hydroceles. The first technique, plication of the sac (Lord’s procedure) is used for small to medium hydroceles. The benefits of this technique are reduced risk of hematoma (localized collection of blood). Some articles suggest a slight incidence of recurrence of the hydrocele following this procedure. The second technique, where the sac is everted and sutured behind the testis (Jaboulay procedure), is associated with a reduced risk of recurrence, but patients may have an increased risk of hematoma.
Again, both techniques are effective treatments for hydroceles. Surgical approaches are governed by 1) the size of the hydrocele and 2) the experience and preference of the surgeon.
Good Luck to you.
---------------------
Information here should be used for patient education only and is not meant to treat or diagnose any condition. Follow-up with a physician is essential.
Hydroceles fluid collections within the tunica vaginalis of the scrotum or along the spermatic cord. Pain or discomfort is a good indication that surgical treatment is warranted.
Both techniques you describe are effective treatments for hydroceles. The first technique, plication of the sac (Lord’s procedure) is used for small to medium hydroceles. The benefits of this technique are reduced risk of hematoma (localized collection of blood). Some articles suggest a slight incidence of recurrence of the hydrocele following this procedure. The second technique, where the sac is everted and sutured behind the testis (Jaboulay procedure), is associated with a reduced risk of recurrence, but patients may have an increased risk of hematoma.
Again, both techniques are effective treatments for hydroceles. Surgical approaches are governed by 1) the size of the hydrocele and 2) the experience and preference of the surgeon.
Good Luck to you.
---------------------
Information here should be used for patient education only and is not meant to treat or diagnose any condition. Follow-up with a physician is essential.
Member Comments
by Amadeo, May 27, 2007 12:00AM
To: Urology - General
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