Treatment of hydrocele by a general surgeon practicing in a rural resource-poor setting in Africa

Abstract

Hydrocele in adults is a collection of peritesticular fluid between the parietal and visceral layers of the tunica vaginalis testis. An endemic disease in Africa, its cause is either idiopathic or a reaction to filariasis. In the absence of treatment, its volume increases spontaneously. The onset of symptoms justifies treatment. In tropical zones, surgery is the most effective treatment. The technique must be simple to perform, require few resources, and limit the risks of complication. Three surgical techniques should be used. In resource-poor practice conditions, fenestration and, to a lesser extent, plication are the techniques most appropriate when the tunica vaginalis is essentially healthy. Only resection is possible when it is damaged.