Inguinal versus Scrotal Approach for The Management of Vaginal Hydrocele in Adult Patients

Background: Hydrocele is one of the commonest causes of painless scrotal swelling which results from a pathological accumulation of serous fluid between the two layers of the tunica vaginalis. The scrotal approach is the standard approach for treating adult vaginalis hydrocele. Scrotal swelling is commonly encountered postoperative complication in such an approach. Objective: This study aimed to improve the postoperative outcomes of hydrocelectomy in adult patients. Patients and methods: This prospective study was conducted on 32 male adult patients with hydrocele in the period from February 2021 to January 2022, in General Surgery Department, Zagazig University Hospitals. The patients were subdivided into two groups: patients in group (1) were managed by hydrocelectomy through scrotal approach, while those in group (2) hydrocelectomy were performed through inguinal approach. Results: The mean age of patients in group (1) was 24.5 ± 4.81664 years versus 25.4375 ± 5.31625 years in group (2). Persistent postoperative scrotal edema for more than one month was encountered in five patients in group (1), while no patient in group (2) developed persistent postoperative scrotal edema. This was statistically significant (p < 0.05). Conclusion: The inguinal approach was better than the scrotal approach for hydrocelectomy in adults with hydrocele. The inguinal approach provides better postoperative outcomes and more patient satisfaction.