Hydrocelectomy versus conservative follow-up for symptomatic hydroceles in infertile men: A pilot study

Objectives: To evaluate the advantages and disadvantages of hydrocele repair in infertile men. The outcome measures were changes in testicular size, semen analysis, and natural pregnancy rate postoperatively. Methods: This pilot study was conducted between January 2021 and April 2024. Inclusion criteria were male patients with a 1-year history of infertility associated with symptomatic hydroceles >100 mL and abnormal semen parameters. Thirty-one men underwent hydrocele surgery, while 30 opted for conservative follow-up. Repeat semen analysis and testicular ultrasonography were performed 6 months after surgery. Results: Primary infertility was reported in 65% of the patients, and two-thirds had unilateral hydroceles. Both groups were comparable in baseline semen parameters, testicular size, and demographic data. The natural pregnancy rate was documented 1 year after surgery. Pregnancy rates were higher in the surgery group than in the conservative group (7 [22.58%] and 5 [16.67%], respectively), although this difference was not statistically significant. No statistically significant differences were observed in semen analysis post-surgery or follow-up. A mild but statistically significant reduction in testicular size was noted after surgery (p