Inguinal versus Scrotal Approach for Hydrocelectomy in Adults with Idiopathic Hydrocele

Alquraishy, Wissam Khaleel Ghanawi; Alsaadi, Mohanned Mahmood Hussein

doi:10.52573/ipmj.2025.163255

	Inguinal versus Scrotal Approach for Hydrocelectomy in Adults with Idiopathic Hydrocele
Iraqi Postgraduate Medical Journal
Volume 25, Issue 2, April 2026, Pages 225-233 PDF (4.94 M)
Document Type: Research Paper
DOI: 10.52573/ipmj.2025.163255
Authors
Wissam Khaleel Ghanawi Alquraishy^* ¹; Mohanned Mahmood Hussein alsaadi²
¹Urology Unit, General Surgery Department, Al-Imamein AlKadhimein Medical City, Baghdad, Iraq (during study, 2022). Currently, Urologist, Baqubah Teaching Hospital, Diyala Health Directorate, Ministry of Health, Diyala, Iraq.
²Consultant Urologist, Urology Unit, General Surgery Department, Al-Imamein Al-Kadhimein Medical City, Al-Karkh Health Directorate, Ministry of Health, Baghdad, Iraq
Abstract
Background: Hydrocele is a common benign condition in adult males caused by fluid accumulation within the tunica vaginalis, leading to painless scrotal swelling. Aim of the Study: To compare the outcomes of hydrocelectomy using the inguinal versus scrotal approach in adult patients with idiopathic hydrocele. Patients and Methods: This prospective, non-randomized comparative clinical trial was conducted from June 2020 to October 2021 and included 44 adult males (20–65 years) with unilateral idiopathic hydrocele. Patients were allocated into two equal groups (n=22) using a structured allocation method to balance baseline variables. Group I underwent hydrocelectomy via an inguinal approach, whereas Group II underwent a scrotal approach. Primary outcomes included hydrocele sac volume, operative time, hospital stay, postoperative complications, and time to resume normal activities. Results: Mean hydrocele sac volume was 205.18 ± 36.2 mL in Group I and 207.23 ± 34.26 mL in Group II (p = 0.849). Mean operative time was 28.27 ± 4.55 minutes (Group I) and 26.77 ± 3.61 minutes (Group II) (p = 0.232). Postoperative hospital stay was 15.2 ± 5 hours (Group I) vs. 18.7 ± 5.5 hours (Group II) (p = 0.032). Postoperative complications occurred in 4.55% of Group I and 27.27% of Group II (difference = 22.72%; 95% CI: 2.35% to 43.09%; p = 0.039). Time to return to normal activities was shorter in Group I (11.31 ± 2.0 days) than Group II (15.09 ± 3.17 days) (mean difference = 3.78 days; 95% CI: 2.25–5.31; p < 0.001). Conclusions: The inguinal approach is a potential favorable option for idiopathic unilateral hydrocele surgery in adults, associated with fewer postoperative complications, shorter hospital stay, faster recovery, and earlier return to normal activities compared to the scrotal approach. It also allows evaluation and treatment of concurrent inguinal pathologies.
Keywords
Hydrocelectomy; Adult; Idiopathic hydrocele; Inguinal approach; Scrotal approach

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