Sclerotherapy
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I wanted to give a shout out to a successful sclerotherapy experience. I had a hydrocele for a few years and it had reached baseball size and was creating discomfort. I was concerned about the standard surgery for the reasons we are all aware of. Sclerotherapy seemed more prevalent outside the U.S. but I found a high volume big city urology clinic that performed sclerotherapy regularly.
My experience was excellent. The procedure takes less than an hour and is not only outpatient but you can drive yourself home. You should not exercise for about two weeks after the procedure and you'll have some discomfort at the site but it is mild (I never took even OTC pain meds).
In my case, I actually had the procedure four times over the course of the year. The first three times the hydrocele was gone but returned within a week but was slightly smaller. Interestingly, after the fourth time the hydrocele did not return and it completely resolved (this was over a year ago and still fully resolved). The doctors mentioned that people normally do the procedure up to three times but did not consider it a risk for me to try the fourth time. I think the only indication where sclerotherapy is not recommended is if you have a septated hydrocele which means your hydrocele has multiple pockets instead of one singular cavity because it's less likely the sclerosing agent will be successful in binding the hydrocele closed.
There are studies that show that sclerotherapy has a lower success rate, but that should be balanced with the fact that it is cheaper, less invasive, and if it doesn't work you could always pursue a traditional surgical option. While I am only one data point, and I did do the procedure four times (which is not the norm), I had a full resolution of the hydrocele without surgery, so I am happy with the result.
Surgery is of course the current medical standard and a perfectly viable option, but there is more risk of complications and the recovery time is much longer. If you are concerned with the surgical option for whatever reason, it may be worth exploring sclerotherapy at a reputable facility.
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