Endoscopic versus open hydrocelectomy for the treatment of adult hydroceles: a randomized controlled clinical trial.

Objective: To compare outcomes of endoscopic treatment of hydrocele with conventional open hydrocelectomy regarding complications and patient satisfaction.

Methods: Patients with clinically significant hydroceles were prospectively enrolled into two treatment groups. Groups 1 and 2 consisted of patients who underwent endoscopic (n = 27) and open surgical treatments (n = 27), respectively. Outcome measures were perioperative and postoperative complications and recurrence rates.

Results: Hydrocele recurred in the first two cases in Group 1 during the initial phase of the learning curve of the technique. No recurrence was encountered in Group 2. As a complication, moderate to severe edema occurred in 4 cases in the endoscopic group. In the open surgery group, significant edema and hematoma occurred in 8 and 2 cases, respectively. On the first and tenth postoperative days, endoscopic procedure was found more cosmetically acceptable and covered a more comfortable convalescence period when compared to open surgical group (P < 0.05). In Groups 1 and 2, 88 and 70% of the patients, respectively, declared that they would recommend this procedure to their friends (P < 0.05).

Conclusions: Endoscopic method is a viable option in the treatment of hydrocele. Outstanding feature of the endoscopic method is an earlier achievement of a better cosmetic outcome and a comfortable postoperative period when compared with the conventional treatment.