Remote Outcomes of Sclerotherapy with Ethanol in Hydrocele Patients

1Z.A. Kadyrov, O.B. Zhukov, R.Kh. Olimov, M.V. Faniev and N.V. Demin


Introduction. Conventional methods of treating hydrocele are rather traumatic and seem unsatisfying to both doctors and patients; therefore, their improvement is is needed. Objective of this study is to evaluate the efficiency and safety of sclerotherapy of hydrocele with 96% ethanol. Patients: 117 patients aged from 35 to 89, with hydrocele volume over 100 ml, were divided into three groups: 34 patients who received sclerotherapy by the studied method; 25 patients who received conventional sclerotherapy; 58 patients who received a widely adopted surgery. The improved sclerotherapy included 30–40 min exposure to ethanol, subsequent evacuation of ethanol from the scrotum, and repeated injection of 5–10 ml of ethanol without evacuation. Results: In Group I the first sclerotherapy cured 97.1% of patients; in Group II, 72%. During two months after the therapy, complications were observed in 14.5%, 16% and 62.2% of patients, respectively. In Group I, 24 patients assessed tolerability as excellent, 10 patients as good. In Group II only 13 patients assessed tolerability as excellent, while 8 patients marked it poor. In Group III, 20 patients assessed tolerability as excellent and 16 patients as poor. The spermatogenesis rate was 8.7±0.5 before and 8.6±04 after the sclerotherapy (Johnsen scale modified by De Kretser and Holstein). The testicle volume on the hydrocele side was 20.9±1.5 сm3 after sclerotherapy, against 25.2±2.2 сm3 prior to it. The linear blood flow velocity in parenchyma arteries was 0.104+0.020 m/s before and 0.122+0.024 m/s after the sclerotherapy. The average resistivity index in parenchyma arteries was 0.81±0.05 m/s before and 0.74±0.06 m/s after the sclerotherapy. These average values were found to be statistically reliable (р<0.05). No reliable change in the spermogram was revealed 6 months after the treatment. Conclusions. The improved sclerotherapy with 96% ethanol minimized the hydrocele relapse and reduced early postoperative complications. This method showed no adverse effect upon the testicle tissue; on the contrary, it conduced to better blood supply and lymph efflux from the parenchyma, which can be confirmed by the examination results.


Hydrocele, Sclerotherapy, Ethanol, Spermatogenesis.

Paper Details
IssueIssue 5