Introduction
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Introduction
Cystic swellings of the scrotum are a common surgical problem. A cystic
swelling of scrotum not only affects the physical well being of the patient but
also is a mental agony for him. There is a strong feeling of shame and
embarrassment among hydrocele patients along with the problem of sexual
disability1.Men with hydrocele need psychological and social support.
A hydrocoele is an abnormal collection of serous fluid in some part of the
processus vaginalis, usually the tunica vaganalis2. Hydrocele is one of
commonest disease occurring worldwide. It is a common disease in tropical
countries especially where filariasis is common. Hydrocele is one of the
chronic manifestations of lymphatic filariasis among men and there are about 27
million men with hydrocele worldwide1. In India the highest incidence is seen
along the coastal belt. Hydrocele is the most common benign scrotal swelling,
and has been estimated to occur in 1% of the adult male population.3
Conventional treatments include repeated aspiration, aspiration and injection of
sclerosant or surgery. Aspiration and injection of sclerosant can cause severe
pain, and simple aspiration has to be repeated and carries risk of infection and
haematoma formation.4
A majority of these people are aware of the remedy of hydrocele through the
surgery. However, most hydrocele patients have not had a hydrocelectomy due
to the costs involved, loss of working days/wages during hospitalisation and
recuperation after surgery, and lack of a surgical facility in rural public health
institutions.1Hence it is the demand of society that surgery for hydrocele should
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be performed even in the most remote and basic peripheral setup alongside a
world class tertiary institution. In the Indian scenario it is not only expected but
necessary for even the youngest lot of surgeons to perform this procedure with
both fluency and expertise.
However, still the surgery for hydrocele has a significant morbidity rate. The
common complications observed during the surgery of hydrocele are bleeding,
injury to the cord structures and epididymis, torsion of the testis after a faulty
positioning post operatively. Commonest among these is post operative
hematoma which is due to oozing from small vessels.16 Unless meticulous
hemostasis is secured oozing from small vessels may continue into the layers of
the loose scrotal tissue giving rise to a hematoma.Hematoma acts as fertile
pabulum for bacteria, infection may supervene, often facilitated by drainage
tubes.It is apt to say that a patient comes for surgery of a tennis ball and goes
back with a cricket ball, considering the size and weight.
In Odisha, surgeons are performing common surgical procedures for hydrocele
i.e. Lord’s plication and Jaboulay’s procedure as well as the minimal dissection
technique i.e. Sharma and Jhawar technique. Comparison is required to select
the best surgical technique. This study aims at comparing the advantages,
disadvantages, postoperative pain and duration of hospital stay between
Jaboulay’s procedure and Sharma and Jhawar technique.
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Aims
&
Objective
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Aim & Objectives
To compare and study Jaboulay’s procedure and Sharma and Jhawar technique
in terms of
1. Duration of Surgery
2. Postoperative Complications (surgical site events,pain)
3. Hospital stay
4. Time taken for scrotal size to revert back to normal
5. Recurrence
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