Mp11-18 Aspiration & Sclerotherapy vs. Aspiration Alone for the Management of Acquired Hydrocele

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP11)1 May 2024MP11-18 ASPIRATION & SCLEROTHERAPY VS. ASPIRATION ALONE FOR THE MANAGEMENT OF ACQUIRED HYDROCELE Carlos Munoz-Lopez, Riley A. O'toole, Prajit Khooblall, Scott D. Lundy, Petar Bajic, Neel Parekh, Bradley C. Gill, and Sarah C. Vij Carlos Munoz-LopezCarlos Munoz-Lopez , Riley A. O'tooleRiley A. O'toole , Prajit KhooblallPrajit Khooblall , Scott D. LundyScott D. Lundy , Petar BajicPetar Bajic , Neel ParekhNeel Parekh , Bradley C. GillBradley C. Gill , and Sarah C. VijSarah C. Vij View All Author Informationhttps://doi.org/10.1097/01.JU.0001008564.85995.11.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Approximately 1% of men will develop an adult noncommunicating hydrocele over their lives. While hydrocelectomy remains the traditional treatment, aspiration and sclerotherapy (S) or aspiration alone (A) are common and inexpensive office procedures used to treat acquired hydrocele with limited data on longitudinal durability. We aim to describe the treatment outcomes of S vs A for management of acquired hydrocele as measured by progression to hydrocelectomy. METHODS: We performed a single-center, retrospective cohort study of men who underwent S or A for treatment of primary/recurrent hydrocele (2016-2023) with a primary outcome of hydrocelectomy after either S or A. Log-rank analysis was used to quantify time to surgery following S or A. Multivariate logistic regression was used to identify independent predictors of progression to hydrocelectomy. RESULTS: Of 150 patients, 84(56%) patients were managed with S while 66(44%) were managed with A. Demographic characteristics between groups were comparable. Median volume drained from aspiration in both cohorts was 200mL. Doxycycline dosage ranged from 50-300mg depending on estimated hydrocele size. Salvage hydrocelectomy was performed in 20% of our overall cohort (S=15% vs A=26%, p=0.1). Median time to hydrocelectomy in the S and A groups was 16 and 12 weeks, respectively (Figure 1). Most patients who proceeded to hydrocelectomy did so within 1 year regardless of aspiration treatment (84% 11/13 in the S group vs 82% 14/17 in the A group). On multivariate analysis, a history of prior inguinal surgery was independently associated with progression to hydrocelectomy (OR: 5.7, 95th CI: 2.3-14.1, p<0.01). S was not protective of hydrocelectomy compared to A (OR: 0.5, 95th CI: 0.2-1.3 p=0.18). CONCLUSIONS: Both sclerotherapy and aspiration alone offer a modest potential for durable response for acquired hydrocele and may forego invasive surgical management. Patients with a history of inguinal surgery were nearly five-fold more likely to eventually progress to hydrocelectomy. Otherwise, sclerotherapy did not delay time to surgery compared to aspiration alone. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e158 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Carlos Munoz-Lopez More articles by this author Riley A. O'toole More articles by this author Prajit Khooblall More articles by this author Scott D. Lundy More articles by this author Petar Bajic More articles by this author Neel Parekh More articles by this author Bradley C. Gill More articles by this author Sarah C. Vij More articles by this author Expand All Advertisement PDF downloadLoading ...