eMedicine Specialties > Urology > Common Problems of the Testicle

Hydrocele: Follow-up

Author: Steven L Lee, MD, Chief, Pediatric Surgery, Department of Surgery, Kaiser-Permanente, Los Angeles Medical Center
Coauthor(s): Jeffrey J DuBois, MD, Consulting Staff, Division of Pediatric Surgery, Kaiser Permanente, North Sacramento Medical Center; Shant Shekherdimian, MD, Consulting Surgeon, Department of Surgery, Kaiser Foundation Hospital
Contributor Information and Disclosures

Updated: Apr 1, 2009

Outcome and Prognosis

Inguinal repairs of communicating hydroceles are exceedingly successful, with a less than 1% recurrence rate. If a unilateral approach is completed, the small but recognized risk for a metachronous hydrocele or inguinal hernia developing remains, but the rate is likely less than 10%. Likewise, recurrence after tunica excision is also uncommon.

Future and Controversies

Recently, many surgeons have begun to advocate routine diagnostic laparoscopy of the contralateral groin in patients (particularly children) with unilateral hernias. The premise is that unsuspected contralateral hernias are repaired prior to clinical recognition. However, many more patent processus are being ligated than true hernias are being repaired. Whether an increased use of this technique will reduce the incidence of hydroceles in older children or adults remains to be seen. Furthermore, whether utilization of this intraoperative modality is of any utility in inguinal hydrocele repairs is open for debate.

Medical management, or, more importantly, prevention of patent processus vaginalis, has been theorized as possible after full elucidation of the intricate molecular processes that control fetal cell migration, proliferation, and adherence. Although the idea of preventing hydroceles or indirect hernias is interesting, it is far from being applicable in clinical medicine.

 


More on Hydrocele

Overview: Hydrocele
Workup: Hydrocele
Treatment: Hydrocele
Follow-up: Hydrocele
Multimedia: Hydrocele
References
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References

  1. Clarnette TD, Hutson JM. The genitofemoral nerve may link testicular inguinoscrotal descent with congenital inguinal hernia. Aust N Z J Surg. Sep 1996;66(9):612-7. [Medline].

  2. Bloom DA, Wan J, Kay D. Disorders of the male external genitalia and inguinal canal. In: Kelalis PP, King LR, Belman AB, eds. Clinical Pediatric Urology. 3rd ed. Philadelphia, Pa: WB Saunders; 1992:1015-49.

  3. Campbell MF, Walsh PC, Retik AB, eds. Campbell's Urology. 8th ed. W.B. Saunders Company; 2002.

  4. Depue RH. Maternal and gestational factors affecting the risk of cryptorchidism and inguinal hernia. Int J Epidemiol. Sep 1984;13(3):311-8. [Medline].

  5. Hutson JM, Temelcos C. Could inguinal hernia be treated medically?. Med Hypotheses. 2005;64(1):37-40. [Medline].

  6. Kaye R. Treatment of hydroceles by injection of sclerosing agents. N Engl J Med. Oct 28 1982;307(18):1149-50. [Medline].

  7. Lloyd DA, Rintala RJ. Inguinal hernia and hydrocele. In: O'Neill Jr J, Rowe M, Grosfeld J, Fonkalsrud E, Coran A, eds. Pediatric Surgery. 5th ed. St. Louis, Mo: Mosby-Year Book; 1998:1071-86.

  8. Marshall FF. The management of hydroceles. AUA Update Series. Vol 1. Baltimore, Md; American Urological Association; 1982:. 2-7.

  9. Sagar J, Kumar S, Mondal D, Shah DK. Idiopathic infected hydrocele in a toddler: a case report with review. ScientificWorldJournal. 2006;6:2396-8. [Medline].

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Further Reading

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Keywords

hydrocele, communicating hydrocele, noncommunicating hydrocele, pediatric hydrocele, patent processus vaginalis, scrotal hydrocele, postvaricocelectomy hydrocele, post-varicocelectomy hydrocele, filarial hydrocele, filariasis, iatrogenic hydrocele, posttraumatic hydrocele, post-traumatic hydrocele, reactive hydrocele

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Contributor Information and Disclosures

Author

Steven L Lee, MD, Chief, Pediatric Surgery, Department of Surgery, Kaiser-Permanente, Los Angeles Medical Center
Steven L Lee, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, Association for Academic Surgery, Society of American Gastrointestinal and Endoscopic Surgeons, and Society of Laparoendoscopic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey J DuBois, MD, Consulting Staff, Division of Pediatric Surgery, Kaiser Permanente, North Sacramento Medical Center
Jeffrey J DuBois, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, Association for Academic Surgery, California Medical Association, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Shant Shekherdimian, MD, Consulting Surgeon, Department of Surgery, Kaiser Foundation Hospital
Disclosure: Nothing to disclose.

Medical Editor

Edmund S Sabanegh, MD, Director, Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation
Edmund S Sabanegh, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Society for the Study of Male Reproduction, Society of Reproductive Surgeons, and Southwest Oncology Group
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark Jeffrey Noble, MD, Consulting Staff, Urologic Institute, Cleveland Clinic Foundation
Mark Jeffrey Noble, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Kansas Medical Society, Sigma Xi, Society of University Urologists, and Southwest Oncology Group
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Edward David Kim, MD, FACS, Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

 
 
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