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Evidence summaries

Polidocanol Vs Tetracycline for Sclerotherapy of Testicular Hydrocele or Epididymal Cyst

Tetracycline may be more effective than polidocanol in the sclerotherapy of hydrocele or epididymal cyst, but causes more pain after instillation. The long-term results of both treatments appear to be satisfactory. Level of evidence: "C"

An RCT 1 included 45 subjects with hydroceles or epididymal cysts (spermatoceles). After puncture and aspiration with an infusion needle (Venflon®), either polidocanol (2 ml of 3% solution mixed with 5 ml of 2% lignocaine hydrochloride) or doxicycline (500 mg in 2 ml of water mixed with 5 ml of 2% lignocaine hydrochloride) was instilled. At 9 months of follow-up, 9 of 17 men treated with polidocanol compared with 17 of 20 men with tetracycline (p<0.05). Tetracycline produced some pain for 3 days after treatment (in 14 patients the pain was moderate or strong just after the procedure) while polidocanol was almost pain-free. 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.

Comment: The quality of evidence is downgraded by sparse data and limitations in study methodology (different dosages may have produced different results).

    References

    • Daehlin L, Tønder B, Kapstad L. Comparison of polidocanol and tetracycline in the sclerotherapy of testicular hydrocele and epididymal cyst. Br J Urol 1997 Sep;80(3):468-71. [PubMed]

Primary/Secondary Keywords