Retrosepctive study of sac eversion with minimal separation: surgical experiance of 25 years for hydrocele

Background: Hydrocele is the most common manifestation and an endemic disease in 80 countries. Objectives:To study the mode of presentation of the disease. To study the efficacy of a surgical technique "sac eversion with minimal separation" in the treatment of hydrocele. Methodology/Principal Findings: A total of 1756 patients with uni- or bilateral hydrocele from the various areas were treated in the study. Diagnosis was mostly by clinical examination and supported by ultrasonography. 812 patients have history of filarial epidedymo orchitis. 207 patients had applied counter irritants 1-3 times. 83 patients had under gone sclerozing injection therapy from quacks. In two patients, sac was found to be very thick and requires sac excision. All the patients were prescribed antibiotics for 6 days and analgesics for 3 days. All the patients were followed up for 6 months for any recurrence or complications. 37 patients had stitch abscess. Two patients developed recurrent hydroceles after 3 months. These two patients were operated by junior residents where eversion was not fixed properly. So recurrence developed in these two patients. None of the patients had haematoma or pyocele. 89 patients, who had filarial hydroceles, were not satisfied with decrease in the size after surgery. The testis is itself is increased in size due to disease process in these patients. Conclusions:"Sac eversion with minimal separation" is a simple outpatient procedure can be done under local anaesthesia in primary vaginal hydroceles, filarial hydroceles of moderate size, in patients who had applied counter irritants or had sclerozing agents injections. Post operative pain and oedema is very minimal. Keeping of drain is not required. Hence can be discharged within 4 hours. Recovery observed is faster. 90 % in 1756 patients were fit enough to go to work on 8th day