Does incision of the tunica vaginalis during the Palomo procedure prevent post‐operative hydrocele?

OBJECTIVE: To assess whether incision of the tunica vaginalis of the ipsilateral testis during the Palomo procedure affects the incidence of post-operative hydrocele. PATIENTS AND METHODS: Forty-two patients with varicocele were treated between 1992 and 1996, all undergoing the Palomo procedure. In 15 patients, incision of the tunica vaginalis of the ipsilateral testis was performed with the Palomo procedure, to prevent the formation of hydrocele. All patients were followed at regular intervals, for 3 months to 4 years. RESULTS: Of 27 patients who underwent the Palomo procedure alone, four developed post-operative hydrocele requiring operation. None of those who underwent incision of the tunica vaginalis with the Palomo procedure developed a hydrocele. The duration of hospital stay was the same in both groups (mean 2.5 days). During the follow-up, there was no difference in the size of the testes, as assessed with the Prader orchidometer, between the two groups. CONCLUSION: Incision of the tunica vaginalis of the ipsilateral testis in addition to the Palomo procedure prevents the development of post-operative hydrocele and causes no adverse sequelae.