A randomized trial comparing 2 doses of polidocanol sclerotherapy for hydrocele or spermatocele.

Abstract

PURPOSE:

Polidocanol sclerotherapy for hydrocele or spermatocele combines high efficiency with low morbidity, but the optimal dose is not known. We compared the efficacy and morbidity of 2 or 4 ml polidocanol sclerotherapy for hydrocele or spermatocele.

MATERIALS AND METHODS:

From 1993 to 2005 a double-blind randomized clinical trial was conducted using 2 or 4 ml polidocanol (30 mg/ml) for sclerotherapy of hydrocele/spermatocele in 224 evaluable patients at 3 university hospitals. Fluid was evacuated and 2 or 4 ml polidocanol was administered by a nurse, with the amount injected concealed from others present. At 3-month followup morbidity was ascertained using a questionnaire completed by the patients. Fluid recurrence was determined clinically and generally re-treated.

RESULTS:

After the first treatment, cure was observed in 59% and 47% in the 4 and the 2 ml group, respectively (p = 0.04). More patients in the 4 ml group had complications (31% vs 18%, p = 0.04). Complications were mostly of low or moderate intensity and seldom required medication. After 1 to 4 treatments 200 of 224 patients (89%) were cured and another 10 (5%) had small amounts of residual fluid, with no difference between the groups. Of the patients with hydroceles/spermatoceles larger than 175 ml, 58% and 34% were cured after the first treatment in the 4 and 2 ml groups, respectively (p = 0.012), with no differences in complications between the groups.

CONCLUSIONS:

Polidocanol sclerotherapy was effective for the treatment of hydrocele or spermatocele in our patients, with 94% satisfactory results after 1 to 4 treatments. A dose of 4 ml was superior to 2 ml, particularly for larger hydroceles/spermatoceles.

• Authors: Staffan Jahnson, Dag Sandblom, Sten Holmäng
• Journal: The Journal of urology (J Urol) Vol. 186 Issue 4 Pg. 1319-23 (Oct 2011) ISSN: 1527-3792 [Electronic] United States
• PMID: 21849198 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Sclerosing Solutions
• Polidocanol
• Polyethylene Glycols

Topics

• Adult
• Aged
• Aged, 80 and over
• Double-Blind Method
• Humans
• Male
• Middle Aged
• Polidocanol
• Polyethylene Glycols (administration & dosage, adverse effects)
• Recurrence
• Sclerosing Solutions (administration & dosage, adverse effects)
• Sclerotherapy (adverse effects)
• Spermatocele (therapy)
• Testicular Hydrocele (therapy)