We hypothesized that men who underwent hydrocelectomy and their partners would have improved sexual function in the postoperative period compared to the preoperative period. In our study, we aimed to compare preoperative and postoperative sexual dysfunction in 80 male patients who underwent hydrocelectomy and their partners using nationally validated sexual function assessment questionnaires.
Male patients who underwent hydrocelectomy in our clinic between 2020 and 2024 were included in the study. The study was designed as a prospective cohort. Sexually active patients between the ages of 18-75 years who underwent hydrocelectomy and who had no previous history of scrotal surgery were included. Patients with postoperative complications (large scrotal hematoma), those with mental or physical disabilities, and those with preoperative moderate to severe erectile dysfunction were excluded. Written informed consent was obtained from all patients and their partners. Patients' age, comorbidities, previous operations and presence of penile anomalies were reported. Penile length was measured under similar environmental conditions (air-conditioned room and temperatures ranging from 23 to 25°C). The penis was measured from the base to the distal tip in the flaccid state by the same physician along the penile dorsum with a millimeter-marked ruler. The largest diameter between the top and bottom of the hydrocele sac was measured and reported as vertical hydrocele size, and the largest diameter between lateral and medial was measured and reported as transverse hydrocele size by the same physician.
Assessment of sexual function All patients and their partners were interviewed face-to-face, social distancing rules were observed and sexual function assessment questionnaires were administered. The questionnaires were administered preoperatively and at 1 month postoperatively. For male patients, the nationally validated International Index of Erectile Function (IIEF) questionnaire consisting of 15 questions with a maximum total score of 75 was administered. This questionnaire includes 5 subgroups: erectile function, orgasmic function, sexual desire, sexual satisfaction and overall satisfaction (8). Female partners were assessed using the Female Sexual Function Index (FSFI), which consists of 19 questions and has a maximum total score of 36. This questionnaire includes 6 subgroups: sexual desire, sexual arousal, lubrication, orgasm, satisfaction and pain (9).
Statistical Analysis Post Hoc Power analysis was performed. (G\*Power 3.1.9.7 software, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). When the effect size was taken as 0.5 and the study power was calculated as 90%, the number of patients required for the study was calculated as 44 with a margin of error of 0.05.
While evaluating the data obtained in the study, IBM SPSS (Statistical Package for the Social Sciences) program version 20 was used for statistical analysis (SPSS, Chicago, IL). Shapiro-Wilk and P-P plot analysis were used to test the conformity of continuous data to normal distribution. Data conforming to normal distribution were reported as mean ± standard deviation (SD) and data not conforming to normal distribution were reported as median (minimum-maximum). Categorical data were given as number and percentage (%) and Pearson Chi-square test was used to compare categorical data between groups. Paired samples t-test was used to compare preoperative and postoperative sexual function assessment questionnaires and subgroups. All statistical tests were two-tailed and p\<0.05 was considered statistically significant.
