抽吸与硬化疗法：治疗鞘膜积液和精索囊肿的微创手段。

Aspiration and Sclerotherapy: A Minimally Invasive Treatment for Hydroceles and Spermatoceles.

机构信息

Division of Urology, Rush University Medical Center, Chicago, IL.

出版信息

Urology. 2022 Jun;164:273-277. doi: 10.1016/j.urology.2021.12.009. Epub 2021 Dec 29.

DOI:10.1016/j.urology.2021.12.009

PMID:34968574

Abstract

OBJECTIVE

To describe our contemporary experience with aspiration and sclerotherapy (AS) as a non-surgical alternative for patients with symptomatic hydrocele and spermatocele who prefer non-surgical treatment.

MATERIALS AND METHODS

Patients were identified by billing diagnosis code for hydrocele or spermatocele from 2015 to 2019. Patients underwent AS with doxycycline (200-400 mg). Physical examination, ultrasound and aspirate microscopy were used to differentiate hydrocele from spermatocele. Baseline and follow-up data were recorded.

RESULTS

In total, 65 patients underwent AS, 54/65 (83%) for hydrocele and 11/65 (17%) for spermatocele with mean aspirate volumes 307 mL (SD 238 mL) and 138 mL (SD 112 mL), respectively. Follow-up data was available for 38/54 (70%) hydroceles and 8/11 (73%) spermatoceles with median follow-up 28 (IQR 23-41) and 22 (IQR 18.5-30.5) months respectively. Relief of patient reported bother associated with scrotal size occurred in 29/38 (77%) hydroceles and 8/9 (89%) spermatoceles. 2/54 (4%) hydrocele patients developed hematoma managed with in-office aspiration. Immediate post-procedural pain occurred in 2/56 (4%) hydroceles and 2/10 (20%) spermatocele. Post-procedural pain requiring more than 5 tablets of hydrocodone/acetaminophen 5mg/325mg occurred in 2/57 (3%) hydroceles and 2/10 (20%) spermatoceles. Surgical repair was ultimately pursued in 3/38 (8%) and 1/9 (11%) patients with persistent hydrocele and spermatocele respectively.

CONCLUSION

AS is a safe and effective treatment alternative for hydrocele and spermatocele for patients wishing to avoid surgery.

摘要

目的

描述我们目前在有症状性鞘膜积液和精液囊肿患者中应用抽吸和硬化治疗（AS）的经验，这些患者更倾向于非手术治疗。

材料与方法

通过 2015 年至 2019 年的鞘膜积液或精液囊肿的计费诊断代码来识别患者。患者接受了多西环素（200-400mg）的 AS 治疗。体格检查、超声和抽吸镜检用于区分鞘膜积液和精液囊肿。记录基线和随访数据。

结果

共有 65 例患者接受了 AS 治疗，54/65（83%）为鞘膜积液，11/65（17%）为精液囊肿，平均抽吸量分别为 307ml（238ml）和 138ml（112ml）。可获得 38/54（70%）例鞘膜积液和 8/11（73%）例精液囊肿的随访数据，中位随访时间分别为 28（IQR 23-41）和 22（IQR 18.5-30.5）个月。29/38（77%）例鞘膜积液和 8/9（89%）例精液囊肿患者的阴囊大小相关的患者报告困扰得到缓解。2/54（4%）例鞘膜积液患者发生血肿，在局麻下抽吸治疗。2/56（4%）例鞘膜积液和 2/10（20%）例精液囊肿患者术后即刻出现疼痛。2/57（3%）例鞘膜积液和 2/10（20%）例精液囊肿患者需要超过 5 片氢可酮/对乙酰氨基酚 5mg/325mg 来缓解术后疼痛。最终有 3/38（8%）例和 1/9（11%）例持续存在鞘膜积液和精液囊肿的患者分别接受了手术修复。