Outcomes after eversion of sac and subtotal excision of sac in cases of primary hydrocele

Abstract

Background/Aim: Hydrocele is a common disease worldwide, and an effective treatment for it is surgery. The commonly performed procedures for its treatment are a) excisional technique — subtotal excision of the sac and b) Jaboulay’s procedure — eversion of the hydrocele sac. This study aimed to evaluate the merits and demerits of eversion of the sac versus subtotal excision in terms of complications, postoperative hospital stays, and recurrence rate. Methods: This prospective study was conducted at a large surgical center. Patients who presented with scrotal swelling and were diagnosed as primary hydrocele cases constituted the study population (100 in all). Subtotal excisions or eversions of the sac were performed depending on the type of hydrocele encountered preoperatively. Follow-up was done at 1week, 1 month, 3 months, and 6 months postoperatively. Results: Eversion of the sac was done in 70 cases, and subtotal excision was done in 30 cases. Incidence of edema, intense pain, and hematoma formation was higher in the group undergoing excision of the sac compared to those undergoing eversion of the sac. The average postoperative hospital stay was 3–5 days in the eversion group. The average postoperative hospital stay was 7–9 days in the subtotal excision group. No recurrence was noted in either of the study groups during the stays study period. Conclusion: Eversion of the sac was associated with fewer postoperative complications, minimal tissue handling, and good hemostatic control compared to subtotal excision of the sac. Patients who underwent eversion of the sac received earlier discharge than those undergoing a subtotal excision of the sac for primary vaginal hydrocele.