Chloe Shi, Nancy Wei, Sarah Schrup, Abrar Mian, Andres Guillen Lozoya, Elizabeth Bearrick, Matthew Ziegelmann, Tobias Köhler, Landon Trost, Sevann Helo
When compared to standard hydrocelectomy technique, MIMFeT provides comparable efficacy with elimination of bleeding events and reduced postoperative healthcare utilization. These findings support MIMFeT as a particularly advantageous option for patients at elevated bleeding risk and as a scalable, office-based alternative to standard hydrocelectomy that may improve patient outcomes while reducing healthcare resource utilization.
BACKGROUND: Hydrocelectomy is one of the most commonly performed benign scrotal procedures, but postoperative complications such as hematoma, infection, and wound-related issues remain common.Minimally invasive approaches to hydrocelectomy may reduce perioperative morbidity and healthcare utilization. Minimally invasive approaches may reduce perioperative morbidity and postoperative healthcare utilization. The minimal-incision modified fenestration technique (MIMFeT), performed under local anesthesia, has not been evaluated in a multi-surgeon, real-world setting. We conducted a retrospective cohort study comparing outcomes of MIMFeT vs. standard hydrocelectomy.
METHODS: We retrospectively reviewed 313 patients who underwent hydrocelectomy [2018-2024]. Patients underwent either MIMFeT or standard hydrocelectomy based on surgeon preference. The primary outcome was 30-day postoperative complications (bleeding, infection, and/or reoperation). Secondary outcomes included unplanned postoperative healthcare utilization and recurrence.
RESULTS: Among 313 patients (132 MIMFeT; 181 standard), overall complication rates were lower with MIMFeT (6.1% vs. 13%, P=0.057). Bleeding occurred in 6.1% of standard cases and 0% of MIMFeT cases (P=0.003). Rates of infection and reoperation were similar between groups. Patients undergoing MIMFeT also experienced significantly fewer unplanned postoperative patient contacts, including phone calls, portal messages, and clinic visits (43% vs. 59%, P=0.01). One-year recurrence rates were similar between groups.
CONCLUSIONS: When compared to standard hydrocelectomy technique, MIMFeT provides comparable efficacy with elimination of bleeding events and reduced postoperative healthcare utilization. These findings support MIMFeT as a particularly advantageous option for patients at elevated bleeding risk and as a scalable, office-based alternative to standard hydrocelectomy that may improve patient outcomes while reducing healthcare resource utilization.