School of Medicine and Health Sciences Poster Presentations

Title

Incidental Hydrocele Rupture During Vasectomy: A Case Report

Document Type

Poster

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Publication Date

Spring 2017

Abstract

Introduction: Physicians perform vasectomies routinely for male sterilization and birth control. Vasectomy protocol is well established involving isolation and ligation of the vas deferens. The number of vasectomies are estimated in the hundreds of thousands yearly. A hydrocele is a fluid collection around a testicle. Hydrocele rupture during vasectomy is a relatively uncommon occurrence.

Case: 34 yo M with no significant PMH presents for elective vasectomy. No previous urologic issues in the past. Patient consented to procedure and all questions answered.

Patient underwent vasectomy. The vas on the left was successfully ligated and cauterized. Immediately upon reduction of the left sided vas approximately 50cc of clear/yellow fluid rushed out of the scrotum, and then quickly ceased. No further leakage afterwards. No incisions were made in the proximity of the urethra. This was verified by the providers. After observation for several minutes, it was deemed that this fluid was likely secondary to a hydrocele. Vas ligation and cautery on the right side proceeded without any difficulty or complication.

Patient vas samples were obtained and sent to pathology. The samples showed right and left vas deferens with complete cross section of lumens identified. UA obtained post vasectomy was negative (color yellow, clear, negative for glucose, protein, bili, urobili, pH 7, blood, ketones, nitrite, leukocyte esterase, specific gravity 1.012). This was done to ensure integrity of urinary tract. Patient seen for f/u 3 days after procedure with no complications (no fevers, chills, scrotal pain, scrotal swelling, or ecchymosis). Patient did not obtain 6 week semen analysis post op.

Discussion

This case demonstrates the importance of understanding hydrocele as a potential rare complication during vasectomy. If a practitioner suspects hydrocele rupture, he or she should note the quality and amount of fluid as well as rule out other potential causes of fluid leak including the urinary tract or vasculature. Hydrocele rupture is typically a benign intraoperative complication with no major post op complications. Understanding hydrocele rupture during vasectomy will help practitioners react to hydrocele rupture during vasectomy in a efficient and professional manner, with proper work up and follow up.

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Poster to be presented at GW Annual Research Days 2017.

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Incidental Hydrocele Rupture During Vasectomy: A Case Report

Introduction: Physicians perform vasectomies routinely for male sterilization and birth control. Vasectomy protocol is well established involving isolation and ligation of the vas deferens. The number of vasectomies are estimated in the hundreds of thousands yearly. A hydrocele is a fluid collection around a testicle. Hydrocele rupture during vasectomy is a relatively uncommon occurrence.

Case: 34 yo M with no significant PMH presents for elective vasectomy. No previous urologic issues in the past. Patient consented to procedure and all questions answered.

Patient underwent vasectomy. The vas on the left was successfully ligated and cauterized. Immediately upon reduction of the left sided vas approximately 50cc of clear/yellow fluid rushed out of the scrotum, and then quickly ceased. No further leakage afterwards. No incisions were made in the proximity of the urethra. This was verified by the providers. After observation for several minutes, it was deemed that this fluid was likely secondary to a hydrocele. Vas ligation and cautery on the right side proceeded without any difficulty or complication.

Patient vas samples were obtained and sent to pathology. The samples showed right and left vas deferens with complete cross section of lumens identified. UA obtained post vasectomy was negative (color yellow, clear, negative for glucose, protein, bili, urobili, pH 7, blood, ketones, nitrite, leukocyte esterase, specific gravity 1.012). This was done to ensure integrity of urinary tract. Patient seen for f/u 3 days after procedure with no complications (no fevers, chills, scrotal pain, scrotal swelling, or ecchymosis). Patient did not obtain 6 week semen analysis post op.

Discussion

This case demonstrates the importance of understanding hydrocele as a potential rare complication during vasectomy. If a practitioner suspects hydrocele rupture, he or she should note the quality and amount of fluid as well as rule out other potential causes of fluid leak including the urinary tract or vasculature. Hydrocele rupture is typically a benign intraoperative complication with no major post op complications. Understanding hydrocele rupture during vasectomy will help practitioners react to hydrocele rupture during vasectomy in a efficient and professional manner, with proper work up and follow up.