Aktuelle Urologie · 2026
[Polidocanol Sclerotherapy for the Treatment of Symptomatic Hydroceles: Establishment of a Minimally Invasive Treatment Concept at a German Center].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Filmar Simon, Hook Sophia, Hartung Friedrich Otto, Althöfer Laura Isabel, Bormann Louisa Charlotte, Netsch Christopher, Becker Benedikt
Аннотация
INTRODUCTION: Hydrocele is a common cause of scrotal swelling in adult men. Surgical treatment is considered the gold standard but is invasive and associated with perioperative morbidity and prolonged recovery. Aspiration followed by sclerotherapy represents a minimally invasive alternative, for which data from German-speaking countries are limited. This study aimed to establish hydrocele sclerotherapy at our center and evaluate its safety and effectiveness.
MATERIALS AND METHODS: This monocentric observational study consecutively included men aged ≥18 years with symptomatic primary hydrocele treated between December 1, 2024 and December 31, 2025. After complete ultrasound-guided aspiration, 4 mL of 3% polidocanol were instilled under local anesthesia in an outpatient setting. The primary endpoint was a clinically satisfactory reduction in hydrocele size or complete regression. In cases of recurrence, repeat sclerotherapy or surgery was offered depending on symptoms. Follow-up included a clinical examination and ultrasound after 6 weeks and telephone follow-up on June 1, 2026. Complications were classified according to the Clavien-Dindo classification.
RESULTS: A total of 32 patients with a mean age of 61.6 ± 15.7 years were treated. Mean aspirated volume was 460.0 ± 382.2 mL. After primary sclerotherapy, 23/32 patients (71.9%) achieved the primary endpoint. Recurrence requiring treatment occurred in 9/32 patients (28.1%), and 7 underwent repeat sclerotherapy. Overall, 28/32 patients (87.5%) were successfully treated with a maximum of 2 procedures, while 4 underwent surgery. Pain occurred in 2 patients (Clavien-Dindo grade I) after primary sclerotherapy. Following repeat treatment, infectious complications occurred in 2 patients, including 1 case requiring surgical revision (Clavien-Dindo grade IIIb).
CONCLUSIONS: Aspiration followed by polidocanol sclerotherapy is an effective outpatient treatment for symptomatic hydrocele. The success rate was 71.9% after a single treatment and 87.5% after a maximum of 2 treatments. Surgery remains the gold standard, while sclerotherapy represents an effective minimally invasive alternative.
MATERIALS AND METHODS: This monocentric observational study consecutively included men aged ≥18 years with symptomatic primary hydrocele treated between December 1, 2024 and December 31, 2025. After complete ultrasound-guided aspiration, 4 mL of 3% polidocanol were instilled under local anesthesia in an outpatient setting. The primary endpoint was a clinically satisfactory reduction in hydrocele size or complete regression. In cases of recurrence, repeat sclerotherapy or surgery was offered depending on symptoms. Follow-up included a clinical examination and ultrasound after 6 weeks and telephone follow-up on June 1, 2026. Complications were classified according to the Clavien-Dindo classification.
RESULTS: A total of 32 patients with a mean age of 61.6 ± 15.7 years were treated. Mean aspirated volume was 460.0 ± 382.2 mL. After primary sclerotherapy, 23/32 patients (71.9%) achieved the primary endpoint. Recurrence requiring treatment occurred in 9/32 patients (28.1%), and 7 underwent repeat sclerotherapy. Overall, 28/32 patients (87.5%) were successfully treated with a maximum of 2 procedures, while 4 underwent surgery. Pain occurred in 2 patients (Clavien-Dindo grade I) after primary sclerotherapy. Following repeat treatment, infectious complications occurred in 2 patients, including 1 case requiring surgical revision (Clavien-Dindo grade IIIb).
CONCLUSIONS: Aspiration followed by polidocanol sclerotherapy is an effective outpatient treatment for symptomatic hydrocele. The success rate was 71.9% after a single treatment and 87.5% after a maximum of 2 treatments. Surgery remains the gold standard, while sclerotherapy represents an effective minimally invasive alternative.