If ultrasonography is available, locate the optimal site of puncture (to avoid damage to the testicle). Mark the site of puncture. After cleansing the skin with e.g. chlorhexidine, infiltrate local anaesthetic, and insert an infusion cannula into the scrotum. Remove the fluid by aspiration or just by letting it drop. After most of the fluid has been removed, inject a solution containing 2 ml of 3% polidocanol diluted with 5ml of 1% or 2.5% lidocaine Polidocanol Vs Tetracycline for Sclerotherapy of Testicular Hydrocele or Epididymal Cyst. Squeeze the skin after removal of the cannula to prevent leakage of the sclerosant.
Sclerotherapy for hydrocoele