Minimally Access versus Conventional Hydrocelectomy: A Randomized Trial

1- Minimally access hydrocelectomy: A small scrotal incision 2 cm long is done as well as incision of the Dartos muscles in the same line . The parietal tunica vaginalis is grasped and minimal blunt dissection is made by the aid of index finger and a small hole is made for aspiration of hydrocele fluid . Then a disc of tissue is excised of the parietal tunica vaginalis about double of the skin incision dimension using electrocautery. The edge of the tunica vaginalis is sutured to the Dartos and scrotal skin in an everted manner aiming to expose the visceral tunica toward scrotal skin . Closure with drain and discharge is allowed at the same day. Cephradine 1 gm administered intravenously at the time of induction of anaesthesia or just after the administration of spinal anaesthesia was given followed by another dose 2 h postoperatively. Patients are seen in the second day and examined for scrotal edema and hematoma. In all patients, drains are removed in the second day. All the excised tissues are sent for pathological examination to rule out any epididymal or vasal structures in the specimen. The mean operative is 15 minutes. The total duration of the study period and its follow-up is 60 months 2- Conventional hydrocelectomy: Incision of the hydrocele sac after complete mobilization of the hydrocele. Partial resection of the hydrocele sac, leaving a margin of 1–2 cm. Care is taken not to injure testicular vessels, epididymis or ductus deferens. The edges of the hydrocele sac are sewn together behind the spermatic cord (Winkelmann's or Jaboulay's technique). The mean operative is 27 minutes. The total duration of the study period and its follow-up is 60 months