Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit

Viral S Shah; Kenneth G Nepple; Daniel K Lee

doi:10.1016/j.juro.2014.04.085

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Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit

Journal article

Peer reviewed

Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit

Viral S Shah, Kenneth G Nepple and Daniel K Lee

The Journal of urology, Vol.192(4), pp.1179-1182

10/2014

DOI: 10.1016/j.juro.2014.04.085

PMID: 24768992

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Abstract

Hydrocelectomy and spermatocelectomy are routine scrotal surgeries. A significant number of the surgical specimens are sent for pathology analysis. However, to our knowledge no study has been done to examine outcomes and necessity, which results in significant potentially unnecessary costs to the patient and the health care system. We evaluated outcomes and surgical pathology analysis of hydroceles and spermatoceles. We performed a retrospective, single institution chart review of all patients who underwent initial surgery for hydrocele or spermatocele between January 2000 and August 2013. We determined the number of cases in which a surgical specimen was sent for pathology examination. The cost for each specimen was estimated at the department of pathology. A total of 264 routine scrotal cases were performed during the 14-year period. Surgical specimens were sent for pathology analysis in 102 hydrocelectomy cases (51%) and in 57 spermatocelectomy cases (90%). No pathology specimen showed any indication of malignancy. The estimated direct total cost of pathology analysis was $49,449 in this cohort. No malignancy was detected in 159 hydrocele and spermatocele specimens during the 14 study years, suggesting that the pathology analysis is of little clinical benefit. Forgoing surgical pathology analysis of these specimens would result in significant cost savings to the patient and the health care system.

Testicular Hydrocele - surgery

Costs and Cost Analysis

Follow-Up Studies

Humans

Middle Aged

Testicular Hydrocele - economics

Spermatocele - surgery

Male

Diagnostic Techniques, Urological - economics

Young Adult

Epididymis - pathology

Spermatocele - economics

Adolescent

Testicular Hydrocele - pathology

Aged, 80 and over

Urologic Surgical Procedures, Male - economics

Adult

Aged

Retrospective Studies

Scrotum - pathology

Spermatocele - pathology

Details

Title: Subtitle: Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit
Creators: Viral S Shah - University of Iowa Department of Urology, Iowa City, Iowa
Kenneth G Nepple - University of Iowa Department of Urology, Iowa City, Iowa
Daniel K Lee - University of Iowa
Resource Type: Journal article
Publication Details: The Journal of urology, Vol.192(4), pp.1179-1182
Publisher: United States
DOI: 10.1016/j.juro.2014.04.085
PMID: 24768992
ISSN: 0022-5347
eISSN: 1527-3792
Grant note: T32 GM007337 / NIGMS NIH HHS
Language: English
Date published: 10/2014
Academic Unit: Urology
Record Identifier: 9984051566602771

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