Systematic Review & Meta-Analysis of Current Treatment Options for Hydrocele: Hydrocelectomy vs. Sclerotherapy

Abstract

Objective: We aimed to compare two main treatment approaches - traditional surgery (hydrocelectomy) versus the less invasive sclerotherapy - by examining their effectiveness, safety, and likelihood of recurrence.

Place and Duration of Study: This study was conducted at the College of Medicine, Qassim Universit.

Methods: We found the necessary information by searching three major databases—PubMed, Embase, and the Cochrane Library—for papers published between January 2000 and January 2023. Our final set of studies included randomized trials, as well as cohort studies (with a minimum of 20 participants) and case series (with at least 10 patients). Two independent researchers handled the data extraction and assessed the quality of the included articles. We then employed random-effects models to determine pooled risk ratios (RR) with 95% confidence intervals (CIs) and used Chi-squared and I2 analysis to measure how much the results varied among the studies.

Results: From 15 eligible studies, three provided data for statistical analysis (157 total patients). Both treatments showed similar success rates (RR 1.04; 95% CI 0.99–1.09; p=0.13; I2=0%). Complications occurred at comparable rates between the two approaches, though the types of complications differed comparable (RR 1.52; 95% CI 0.60– 3.84; p=0.38; I2=62%). Long-term effectiveness remains unclear because recurrence rates varied widely across the studies. This is supported by the high heterogeneity (I2=81%) and the non-significant and imprecise pooled Risk Ratio (RR 1.01; 95% CI 0.03–31.73).

Conclusion: Despite surgery being the preferred long-term solution, sclerotherapy provides a viable alternative, especially where resources are scarce. To accurately gauge the long-term efficacy of both treatments, future research must incorporate larger sample sizes and stricter methodological standards.