Comparative analysis of Lord’s plication and Jaboulay’s eversion in the surgical management of primary vaginal hydrocele

Background: Hydrocele, a common benign cause of scrotal swelling, frequently requires surgical correction. Among available techniques, Lord’s plication and Jaboulay’s eversion are widely used, yet evidence comparing their outcomes remains inconclusive, particularly in the Indian context. Aim was to compare postoperative outcomes of Lord’s plication and Jaboulay’s eversion in adult males with primary vaginal hydrocele. Methods: A prospective comparative observational study was conducted at a tertiary care centre between January 2024 and December 2025, enrolling 100 adult male patients with primary vaginal hydrocele. Based on sac wall thickness and size, 71 patients underwent Jaboulay’s eversion and 29 underwent Lord’s plication. Primary outcome was the rate of postoperative complications; secondary outcomes included pain on postoperative day (POD) 3 and 7, hospital stay duration, suture removal day, and recurrence at 6 months. Data followed STROBE guidelines; statistical analysis employed Fisher’s exact and Kruskal-Wallis tests, with p<0.05 considered significant. Results: Postoperative complications occurred in 33% of patients, significantly lower in the Jaboulay group (17%) compared to Lord’s (72%) (p=0.002). Mean hospital stay was shorter following Jaboulay’s eversion (7.08±1.6 days) versus Lord’s plication (8.0±1.75 days; p<0.001). Suture removal occurred earlier after Jaboulay’s (5.9±0.7 days vs 7.2±1.1 days; p=0.002). No recurrence was observed in either group at 6 months. Conclusions: Both procedures effectively treat primary hydrocele; however, Jaboulay’s eversion offers significantly fewer complications, less postoperative pain, and faster recovery. It should be preferred, particularly for large or thick-walled hydroceles.