Consequences of hydrocele and the benefits of hydrocelectomy: a qualitative study in lymphatic filariasis endemic communities on the coast of Ghana.

A study using focus group discussions and in-depth interviews was conducted to determine the consequences of hydrocele and the benefits of hydrocelectomy on physical activity and social life in three lymphatic filariasis endemic villages where males had recently been offered surgical operations to repair their hydroceles. Respondents were of the view that hydrocele, especially large ones, severely reduced the patients' work capacity and impaired sexual function, and that overall it had a considerable negative effect on the quality of living for the patients, their families and the community. The main reasons for refusing hydrocelectomy in the past were the high cost of surgery, and to some extent fear of death, impotence and/or sterility that might result from the operation. The recently offered hydrocele operations, which included 40 males, were financially supported and preceded by appropriate counselling, and from the patients' point of view were highly successful. Patients spent between 4 and 12 days in the hospital and there were no post-operative complications. Patients observed that, between 3 and 6 months after surgery, there were remarkable improvements in their work capacity and sexual function, and restoration of self-esteem, thus enabling them to participate more actively in community activities. The need for hydrocelectomy to be incorporated as an important morbidity control measure in lymphatic filariasis control programmes is discussed.