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Objective: To assess the usefulness of aspiration sclerotherapy in the treatment of hydroceles in the tropics., Patients and Methods: This prospective study included 82 patients with 94 primary vaginal hydroceles of which 62 hydroceles were treated by aspiration and tetracycline hydrochloride sclerotherapy as an outpatient procedure (mean age of patients 56.5 years, range 40-82) and 28 were treated surgically and included as controls (mean age 52.4 years, range 40-70). All patients were followed for a year., Results: In the sclerotherapy group, the overall cure rate after a year was 95%. Few complications were encountered in this group: six patients (10%) experienced pain during the procedure, seven patients (12%) had local infection and three patients (5%) developed haematoma. No recurrence was encountered in the surgical group, seven patients (25%) had infection and two patients (7%) developed haematoma. The mean hospital stay for the surgical group was 3.4 +/- 1.3 days (range 1-7). Four patients with thick-walled hydroceles had persistent swelling after sclerotherapy, the recurrence of which dissatisfied the patients., Conclusions: Aspiration sclerotherapy for thin-walled hydroceles proved to be a curative, simple, safe and cost-effective out-patient procedure. It can be an alternative to surgery in developing countries where resources are limited.

Nine patients with Fournier's gangrene are presented and the relevant literature is reviewed. Fournier's gangrene is secondary to other predisposing conditions, the commonest causes being urethral and perianal sepsis. Local excision and antibiotics are the treatment of choice.

Eleven patients had radiologically non-functioning and unilaterally obstructed kidneys with normal kidneys on the other side. The kidneys were divided into three groups according to the urinary pH of the obstructed kidney at operation: Group 1 (pH 6.0 or less); Group 2 (pH 6.1-7.1); Group 3 (pH greater than 7.1). The obstruction was corrected in all patients despite the pre-operative radiological findings or the morphological appearance at operation. Radiological recovery was assessed 2 months post-operatively and was found to be good in all patients in Group 1. In Group 2, recovery was good in one patient, moderate in two and absent in one. In Group 3 there was no evidence of radiological recovery in either patient.