Minimally invasive technique for treating hydrocele with absolute alcohol

P. G. Knijnik, D. de F. G. Soares, E. T. Lucas, T. Kreutz Grossmann, A. Suarez-Sarmiento, P. Perito, G. V. M. da Silva

Hydrocele, Sclerotherapy, Absolute alcohol, Minimally invasive

The video covers the step-by-step practical technique of hydrocele sclerotherapy

using 99.5% absolute alcohol, demonstrating a minimally invasive alternative to

traditional hydrocelectomy. The procedure is performed on an outpatient presenting

with a 200 ml hydrocele. The technique demonstrated includes the identification of

the puncture area via transillumination to avoid vascular injury, complete fluid

drainage using a 16-gauge angiocatheter, and the sequential intra-vaginal injection

of 2% lidocaine without epinephrine (calculated as 1% of the drained volume) for

pain prevention, followed by the sclerosing agent, 99.5% absolute alcohol

(calculated strictly as 10% of the drained volume with the upper limit of 50 cc of

alcohol). The video outlines the simplicity, cost-effectiveness, and safety of this

approach, making a case that alcohol sclerotherapy is a highly successful first-line

treatment that allows for immediate recovery and is suitable for patients wishing to

preserve fertility.

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Shan CJ, Lucon AM, Pagani R, Srougi M. Sclerotherapy of Hydroceles and Spermatoceles with Alcohol: Results and Effects on the Semen Analysis. Int Braz J Urol. 2011; 37: 307-313.