To compare the middle-term efficacy and safety results between scrotoscope-assisted (SA) minimally invasive excision and traditional open excision (OE) for the treatment of epididymal mass.

A total of 253 males with surgery excision of epididymal mass from 2012 to 2018 were included in this retrospective study. Patients were divided into two groups: the traditional OE group and the SA group. Patient demographics and intraoperative and postoperative outcomes were obtained and compared between these two groups.

About 174 patients (68.8%) underwent SA, and the other 79 (31.2%) underwent OE. Demographic data were similar between the two groups. Compared with OE surgery, SA could significantly shorten the operating time (19.4 ± 4.1 vs. 53.8 ± 12.9 min), reduce blood loss (5.3 ± 1.5 vs. 21.3 ± 5.6 ml), and downsize the operative incision (1.5 ± 0.3 vs. 4.5 ± 0.8 cm). Additionally, postoperative complications were significantly less occurred in the SA group than those in OE (15.5% vs. 21.5%), in particular scrotal hematoma (1.7% vs. 12.7%) and incision discomfort (2.8% vs. 6.3%). Patients in the SA group had a significantly higher overall satisfaction score (94.8 ± 3.7 vs. 91.7 ± 4.9) and a significantly shorter length of hospital stay (4.1 ± 0.9 vs. 5.0 ± 1.5 days) than those in the OE group. No postoperative testicular atrophy occurred in the SA group.

SA is emerging as a novel and effective option with promising perspectives for epididymal mass therapy.

Hydrocelectomy is the gold standard for the treatment of hydrocele, but it often causes complications after surgery, including hematoma, infection, persistent swelling, hydrocele recurrence, and chronic pain. In recent years, several methods for minimally invasive treatment of hydrocele have been introduced, but they all have limitations. Herein, we introduce a new method of individualized minimally invasive treatment for hydrocele.

To present a new method for the treatment of adult testicular hydrocele.

Fifty-two adult patients with idiopathic testicular hydrocele were included. The key point of this procedure was that the scope of the resection of the sheath of the tunica vaginalis was determined according to the maximum diameter (d) of the effusion measured by ultrasound and the maximum diameter of the portion of the sheath pulled out of the scrotum was approximately πd/2. The surgical procedure consisted of a 2-cm incision in the anterior wall of the scrotum, drainage of the effusion, and dissection of part of the sheath of the tunica vaginalis. After the sheath was peeled away to the predetermined target extent, the pulled-out sheath was removed. The intraoperative findings and postoperative complications were analyzed.

All patients were successfully treated with a median operation time of 18 min. The median maximum diameter of the effusion on ultrasound was 3.5 cm, and the median maximum diameter of the resected sheath was 5.5 cm. Complications occurred in four (7.7%) patients: two (3.8%) cases of mild scrotal edema, one (1.9%) case of scrotal hematoma, and one (1.9%) case of wound infection. All of the complications were grade I-II. Recurrent hydrocele, chronic scrotal pain, and testicular atrophy were not observed during a median follow-up of 12 mo.

We report a new technique for individualized treatment of testicular hydrocele, which is quantitative and minimally invasive and yields good outcomes. Further study is warranted to verify its potential value in clinical practice.

To ascertain the acceptability of minimally access hydrocelectomy through a 2-cm incision and the outcome in terms of morbidity reduction and recurrence rate. Although controversy exists regarding the treatment of hydrocele, hydrocelectomy remains the treatment of choice for hydroceles. However, the standard surgical procedures for hydrocele can cause postoperative discomfort and complications.

A total of 42 adult patients, aged 18-56 years, underwent hydrocelectomy as an outpatient procedure using a 2-cm scrotal skin incision and excision of only a small disk of the parietal tunica vaginalis.

The operative time was 12-18 minutes (mean 15). The outcome measures included patient satisfaction and postoperative complications.

This procedure requires minor dissection and minimal manipulation during treatment. It also resulted in no recurrence and minimal complications and required a short operative time.

This prospective study compared the effects of scrotal and inguinal approaches in hydrocele repair. Thirty-two adult patients, enrolled between January 1994 and May 2000, were randomly assigned to an inguinal (n=17) or a scrotal (n=15) approach. Scrotal size (at the surgical site) was measured preoperatively and postoperatively. Edema, infection, and hematoma formation were evaluated on the first, second, and third days after operation. Hematoma occurred in 4 patients in the scrotal approach group and in 1 patient in the inguinal approach group. Scrotal size was significantly smaller in the scrotal approach group on all postoperative evaluation days. Three months after surgery, all patients in both groups were free of hydrocele. The inguinal approach is a feasible option in the surgical treatment of adults with hydrocele; it results in less edema than is noted with the scrotal approach. Larger studies are needed to confirm these results.