Shokeir A A, Eraky I, Hassan N, Wafa E W, Mohsen T, Ghoneim M A
Urology and Nephrology Center, Mansoura University, Egypt.
Urology. 1994 Jul;44(1):96-9. doi: 10.1016/s0090-4295(94)80016-2.
To study the efficacy of tetracycline sclerotherapy in renal transplant recipients with symptomatic hydroceles.
A total of 21 patients with symptomatic hydroceles following renal transplantation underwent aspiration of hydrocele and injection of tetracycline hydrochloride. Sclerosant solution was prepared by dissolving 1 g tetracycline hydrochloride powder in 10 mL 1% lidocaine. The amount of sclerosant used depended on the volume of the sac: 5 mL for a sac containing up to 100 mL and 2.5 mL of sclerosant was added for each increase of 100 mL in sac volume.
Twelve patients (57%) required only one treatment and 9 patients (43%) had up to 3 injections. The larger the hydrocele, the more treatments were required. The resolution of hydrocele was complete in 12 patients (57%) and partial in 7 (33%) with 2 (10%) failures. Pain at injection was observed in one third of the patients. No major complications (fever, hematoma, infections, abscess, or scrotal necrosis) occurred in any patient. No changes in the structure or size of the testicles were found by ultrasound during an average follow-up period of 35 months.
Tetracycline sclerotherapy is a safe, effective, and economical form of out-patient therapy that can be recommended as primary treatment for hydroceles in patients who have undergone renal transplantation.
研究四环素硬化疗法对有症状的肾移植受者鞘膜积液的疗效。
共有21例肾移植后出现有症状鞘膜积液的患者接受了鞘膜积液抽吸及盐酸四环素注射治疗。硬化剂溶液通过将1 g盐酸四环素粉末溶解于10 mL 1%利多卡因中配制而成。所用硬化剂的量取决于囊腔的体积：囊腔容积达100 mL及以下时用5 mL，囊腔容积每增加100 mL则增加2.5 mL硬化剂。
12例患者（57%）仅需一次治疗，9例患者（43%）最多接受了3次注射。鞘膜积液越大，所需治疗次数越多。12例患者（57%）鞘膜积液完全消退，7例（33%）部分消退，2例（10%）治疗失败。三分之一的患者在注射时出现疼痛。所有患者均未发生严重并发症（发热、血肿、感染、脓肿或阴囊坏死）。在平均35个月的随访期内，超声检查未发现睾丸结构或大小有变化。
四环素硬化疗法是一种安全、有效且经济的门诊治疗方式，可推荐作为肾移植患者鞘膜积液的主要治疗方法。
