Can the Hydrocele Sac Dissection Technique Affect the Surgical and Cosmetic Satisfaction Results of Conventional Hydrocelectomy?

Abstract

Aim: In this study, we applied the classical technique and modified open pull-through procedure (OPtP) for hydrocele sac dissection in excisional Winkelmann hydrocelectomy procedure (WHP) to retrospectively compare the surgical and cosmetic satisfaction results of the two techniques. Material and Methods: Sixty-two patients underwent excisional WHP from 2017 to 2020. The modified OPtP and classical technique groups included 30 and 32 patients, respectively. The intraoperative and postoperative parameters of the patients in both groups were evaluated statistically until the postoperative second month. Cosmetic satisfaction was evaluated statistically at the postoperative sixth month. Results: Postoperative infection and recurrence were not observed in either group. The patients in both groups had large hydrocele sacs. There was no statistically significant difference between the groups in terms of the hydrocele sac volume, operation time, length of hospitalization, postoperative scrotal edema, and postoperative scrotal pain scores (p>0.05). The postoperative hematoma rate was 15.6% in the classical technique group. The statistical difference in incision length and cosmetic satisfaction was significant in favor of the modified OPtP group (p<0.05). Conclusion: Excisional WHP was determined to be safe in the treatment of large hydroceles. In the modified OPtP group, shorter scrotal incision length and low risk of postoperative scrotal hematoma were achieved, and cosmetic satisfaction was also increased.