Complications of scrotal surgery for benign conditions.
OBJECTIVE
Frequent complications have been reported after scrotal surgery. We reviewed our experience to determine the complication rates, risk factors, and how our experience might differ from other series.


METHODS
We reviewed all scrotal surgery for benign conditions at the Veterans Affairs Puget Sound Health Care System from 1998 to 2004. The abstracted data included indications, comorbidities, perioperative antimicrobial use, operative procedures, use of drains, and complications.


RESULTS
Ninety-five patients underwent 110 procedures, including hydrocelectomy (55%), spermatocelectomy (15%), epididymectomy (4%), and bilateral or combination procedures (27%). Preoperative antimicrobial administration was documented before 80 (73%) of the 110 procedures. The follow-up ranged from 0 to 85 months (mean 36). Complications occurred after 22 (20%) of the 110 procedures and included recurrences (6%), hematomas (5%), and infections (3.6%), with 95% of complications occurring after hydrocelectomy (odds ratio 9.1, 95% confidence interval 1.1 to 71.6). The potential patient and surgical risk factors considered were immunocompromised status, undergoing a bilateral procedure, a high American Society of Anesthesiologists score, body mass index, and the use of drains.


CONCLUSIONS
Our overall complication rate was 20%, with most occurring after hydrocele surgery (chi-square, P = 0.01). The 3.6% wound infection rate was substantially lower than that in recent series in which preoperative antimicrobial agents were not prescribed. In the absence of a prospective clinical trial, these findings suggest that scrotal procedures might merit consideration of routine antimicrobial prophylaxis.
Swartz
Mia A
MA
Department of Urology, University of Washington School of Medicine, Seattle, Washington 98195, USA. maswartz@u.washington.edu
Morgan
Todd M
TM
Krieger
John N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005832:Genital Diseases, Male / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012611:Scrotum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology