Comparison of polidocanol and tetracycline in the sclerotherapy of testicular hydrocele and epididymal cyst.

Author(s): Daehlin L, Tonder B, Kapstad L

Affiliation(s): Department of Surgery, Haukeland Hospital, Bergen, Norway.

Publication date & source: 1997-09, Br J Urol., 80(3):468-71.

Publication type: Clinical Trial; Randomized Controlled Trial

OBJECTIVE: To compare the effects and side-effects of polidocanol and tetracycline when used as sclerosants for testicular hydrocele and epididymal cyst. PATIENTS AND METHODS: Forty-five men (median age 67 years, range 42-81) with 46 hydroceles or epididymal cysts were assessed. After puncture and aspiration, the empty sac was instilled with either polidocanol or tetracycline, assigned randomly. Patients recorded any treatment-associated pain on a visual analogue scale. RESULTS: At 9 months of follow-up, nine of 17 men were cured after sclerotherapy with polidocanol compared with 17 of 20 men treated with tetracycline (P < 0.05). Tetracycline produced some pain for 3 days after treatment while polidocanol therapy was almost pain-free. Re-instillation should be considered for recurrences. At the follow-up after 35 months, 16 of 18 men treated with polidocanol and 20 of 22 men treated with tetracycline were satisfied with the outcome. CONCLUSION: Both polidocanol and tetracycline are useful sclerosants for treating testicular hydrocele and epididymal cyst. We prefer polidocanol as a first choice in older patients because there were few short-term side-effects.