Department of General Surgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India.
Department of Emergency Medicine, NSCB Medical College, Jabalpur, Madhya Pradesh, India.
Int Urol Nephrol. 2024 Jan;56(1):29-33. doi: 10.1007/s11255-023-03768-x. Epub 2023 Sep 1.
Surgical procedures for vaginal hydroceles have been varied with the aims of preventing recurrence, hematoma and edema formation and providing a better cosmetic outcome. The Jaboulay's procedure remains a preferred procedure owing to its simplicity and good long term outcome. However, sac eversion during the procedure leads to scrotal edema and mass sensation due to remnant sac in cases of large or secondary hydrocele sacs. Sac excision in these cases may provide better outcomes by removing the excess tissue. We aimed to compare the postoperative outcome after Jaboulay's procedure and harmonic scalpel excision of the sac in terms of scrotal edema, hematoma formation and the final cosmetic appearance.
72 adult patients with vaginal hydrocele were randomized into two groups, who underwent harmonic scalpel sac excision and Jaboulay's procedure respectively, performed by a single surgeon. Preoperatively, patient demographics were noted. Postoperatively, data was recorded on the 1st day, 3rd day & 10th day about postoperative complications, and outcomes. Satisfaction on final cosmetic outcome was compared between the groups at the 3rd month.
Post operative edema and sensation of mass in the scrotum were more (but not significant) in the Jaboulay's procedure group. Seroma and wound infection rates were similar in both groups. Patient satisfaction on cosmesis was better in the sac excision group.
Hydrocelectomy with excision of the sac using a harmonic scalpel results in a lower incidence of postoperative oedema and better patient satisfaction in terms of cosmetic outcome compared to Jaboulay's procedure in the treatment of adult hydroceles.
阴道阴囊积水的手术方法多种多样，目的是预防复发、血肿和水肿形成，并提供更好的美容效果。Jaboulay 手术因其简单性和良好的长期效果仍然是首选手术。然而，在手术过程中，由于残余囊袋，大的或继发性阴囊积水囊袋会导致囊袋外翻，引起阴囊水肿和肿块感。在这些情况下，切除囊袋可能通过去除多余组织提供更好的结果。我们旨在比较 Jaboulay 手术和超声刀切除囊袋在阴囊水肿患者中的术后结果，包括阴囊水肿、血肿形成和最终美容外观。
72 例成人阴道阴囊积水患者随机分为两组，分别接受超声刀囊袋切除术和 Jaboulay 手术，由一名外科医生完成。术前记录患者的人口统计学资料。术后第 1、3 和 10 天记录术后并发症和结果的数据。术后 3 个月比较两组患者对最终美容结果的满意度。
Jaboulay 手术组术后阴囊水肿和肿块感更明显（但无统计学意义）。两组的血清肿和伤口感染率相似。在美容效果方面，囊袋切除组的患者满意度更高。
与 Jaboulay 手术相比，在成人阴囊积水的治疗中，使用超声刀切除囊袋的积水切除术术后水肿发生率较低，患者对美容效果的满意度更高。
