The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele

Objective To assess the results of the excision, plication and internal dra inage techniques for hydrocele repair. Patients and methods Between January 1990 and June 1998, 132 patients (mean age 54.36 years, range 16-83) underwent repair for idiopathic hydrocele us ing one of three techniques (excision, eversion/plication or internal drain age); the complication and recurrence rates of each technique were evaluate d. Results The excisional technique resulted in the highest complication rate (81%) and the internal drainage technique the lowest (7%). Postoperative sc rotal oedema occurred in 74% of patients after plication and this was the h ighest rate among the techniques (P < 0.001). Differences in the rates of w ound infection and haematoma among the three techniques were not statistica lly significant. The internal drainage technique had the highest recurrence rate (85%) and the excisional technique the lowest (1.3%; P < 0.001), Conclusions Although useful, the internal drainage technique has a high rec urrence rate and we suggest abandoning its use for hydrocele repair. The pr esent results suggest: that plication is better than excision, causing fewe r complications, and better than internal drainage, as the results are more favourable.