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Filmar S, Gross AJ, Hook S, Rosenbaum CM, Netsch C, Becker B. [Hydrocele]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:607-617. [PMID: 38780784 DOI: 10.1007/s00120-024-02367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
The hydrocele is overall a rare condition in urology. A differentiation between primary and secondary hydrocele is essential for further treatment. A primary hydrocele with a patent vaginal process tends to spontaneously regress in the first 2 years of life in newborns. If treatment is necessary, open as well as laparoscopic methods are available with good results. The treatment of scrotal pathologies, especially secondary hydrocele, often poses a challenge in the clinical practice. Despite the benign nature, supposedly simple surgical techniques and good chances of healing, postoperative complications are frequent. In comparison to open surgery, sclerotherapy provides a good alternative for the treatment of secondary hydrocele.
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Affiliation(s)
- S Filmar
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland.
| | - A J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland
| | - S Hook
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland
| | - C M Rosenbaum
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland
| | - C Netsch
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland
| | - B Becker
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland
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BAWAZIR OA, ALSAEGH MO. Orchidopexy during inguinoscrotal hydrocele repair: is it necessary? Chirurgia (Bucur) 2022. [DOI: 10.23736/s0394-9508.21.05259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tanimola AG, Talabi AO, Sowande OA, Adejuyigbe O. Comparison of the Inguinal and High Scrotal Approaches for the Treatment of Inguinal Hernias in Boys. Ethiop J Health Sci 2021; 31:771-778. [PMID: 34703176 PMCID: PMC8512952 DOI: 10.4314/ejhs.v31i4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background The conventional groin incision herniotomy is still being adhered to despite high success rate of high scrotal approach. Hence, the aim of this study was to compare the outcomes of high scrotal and conventional approaches for the treatment of inguinal hernia in boys. Methods A prospective study of 100 boys with 108 inguinal hernias whose ages were less than 15 years. They were randomized into 2 groups; high scrotal and conventional approaches. Ninety-four patients with 101 hernias were analyzed. The operative time, conversion rate (high scrotal approach), and postoperative complications were reported. Results A total of 100 boys with 108 hernias were enrolled but 94 patients with 101 hernias were analyzed. They comprised of 48 patients with 51 hernias in the high scrotal group and 46 patients with 50 hernias in the conventional group. Their age range was between 2 months and 168 months with a mean of 47.9 ± 46.7 months. The conversion rate of high scrotal approach was 1.9%. The mean duration of operation in the high scrotal group was 37.1 ± 13.3 minutes compared with 37.2 ± 15.1 minutes in the conventional group, p = 0.982. Early postoperative scrotal edema was more in the high scrotal group compared to the conventional group, p = 0.018. The Hollander wound evaluation score was better in the high scrotal incision compared to the conventional approach, p = 0.003. Conclusion The high scrotal approach may be an alternative to conventional herniotomy in boys.
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Affiliation(s)
- Adebayo Gbenga Tanimola
- Division of Paediatric Surgery, Department of surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Ademola Olusegun Talabi
- Division of Paediatric Surgery, Department of surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Oludayo Adedapo Sowande
- Division of Paediatric Surgery, Department of surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Olusanya Adejuyigbe
- Division of Paediatric Surgery, Department of surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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Oh JH, Chung HS, Yu HS, Kang TW, Kwon D, Kim SO. Hydrocelectomy via scrotal incision is a valuable alternative to the traditional inguinal approach for hydrocele treatment in boys. Investig Clin Urol 2018; 59:416-421. [PMID: 30402575 PMCID: PMC6215779 DOI: 10.4111/icu.2018.59.6.416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/01/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose Few studies have explored the treatment of isolated communicating hydroceles via scrotal incision. We prospectively evaluated the surgical outcomes of such treatment in boys with hydroceles compared with that using traditional, inguinal incision hydrocelectomy. Materials and Methods Of 347 boys aged 0–12 years who were diagnosed as hydrocele on ultrasonography, 173 boys were assigned to the scrotal incision hydrocelectomy group (group I, n=173) and 172 boys were assigned to the traditional inguinal incision hydrocelectomy group (group II, n=172), and finally 156 boys in group I and 156 boys in group II were included in this study. Surgical outcomes, including postoperative complications and hydrocele relapse rates, were compared between groups. Results The overall success rates were similar in both groups (group I, 96.8%; group II, 89.1%; p=0.740). The operation time and hospital stay were significantly shorter in group I (30.94±3.95 minutes and 3.94±0.30 days) than in group II (38.02±7.12 minutes and 4.24±0.99 days; p<0.001 and p=0.009, respectively). The postoperative complication rate was lower in group I than in group II (3.2% vs. 10.9%, p=0.740). Conclusions Scrotal incision hydrocelectomy in boys was associated with shorter operative time and hospital stay, and a lower postoperative complication rate, than was the inguinal incision approach. The scrotal incision technique might be an easy and effective alternative treatment when used to treat hydroceles in boys as well as inguinal incision approach.
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Affiliation(s)
- Jeong Hoon Oh
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Song Yu
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Dongdeuk Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Ouck Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
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Talabi A, Sownde O, Adejuyigbe O. High (trans) scrotal orchidopexy for palpable undescended testes in children: Influence of age and testicular position. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lin J, Li D, Chen J, Lin L, Xu Y. Inguinal hernia repair by Bianchi incision in boys: a retrospective study. Pediatr Surg Int 2018; 34:289-295. [PMID: 29188379 DOI: 10.1007/s00383-017-4217-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Open inguinal hernia repair by Bianchi incision is a potential alternative technique for the treatment of IH. This study aims to retrospectively analyze boys with IH, who underwent open IH repair by Bianchi incision. METHODS A total of 3300 boys (1-144 months) with IH from April 2007 to September 2015 were enrolled into this study. An open high scrotal incision (Bianchi incision) to ligate the processus proximal to the internal inguinal ring was performed in patients for IH repair. Then, all patients were followed up after 7 days, 1 month, and 1 year. Operation time, hernia recurrence, hydrocele, testicular atrophy, cosmetic results, and the satisfaction of parents were evaluated. RESULTS Among these 3300 boys, 1662 (50.36%) and 1349 (40.88%) boys with IH were operated on the right and left side, respectively, while 289 (8.76%) patients underwent bilateral surgery. The average operation time was 13.0 ± 2.3 min for unilateral cases and 25.2 ± 4.2 min for bilateral cases. Furthermore, among these 3300 boys, 309 boys (9.36%) were lost to follow-up, and the remaining 2991 boys underwent a total of 3245 IH repairs. The complications included 20 recurrences who were repaired with the same technique, one wound rupture, and one acquired undescended testis. No infection, obvious scrotal hematoma, testicular atrophy, and vas deferens injury were found during the follow-up. In most instances, the scars were invisible, obtaining an excellent cosmetic effect. CONCLUSION Inguinal hernia repair by Bianchi incision is a safe, easy and effective technique with cosmetic benefits, which could be a reliable alternative for the treatment of pediatric inguinal hernia.
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Affiliation(s)
- Junshan Lin
- Pediatric Surgery Department of the First Affiliated Hospital of Fujian Medical University, The First Clinical Medical College of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350004, Fujian, China
| | - Dumiao Li
- Pediatric Surgery Department of the First Affiliated Hospital of Fujian Medical University, The First Clinical Medical College of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350004, Fujian, China
| | - Jinwen Chen
- Pediatric Surgery Department of the First Affiliated Hospital of Fujian Medical University, The First Clinical Medical College of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350004, Fujian, China
| | - Li Lin
- Pediatric Surgery Department of the First Affiliated Hospital of Fujian Medical University, The First Clinical Medical College of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350004, Fujian, China
| | - Yali Xu
- Pediatric Surgery Department of the First Affiliated Hospital of Fujian Medical University, The First Clinical Medical College of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350004, Fujian, China.
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Pediatric Urology for the General Surgeon. Surg Clin North Am 2016; 96:545-65. [PMID: 27261794 DOI: 10.1016/j.suc.2016.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pediatric urology spans the neonatal period through the transition into early adulthood. There are a variety of common pediatric urologic conditions that overlap significantly with pediatric surgery. This article reviews the pertinent pathophysiology of a few key disease processes, including the pediatric inguinal hernia and/or hydrocele, cryptorchidism, and circumcision. General surgeons may find themselves in the position of managing these problems primarily, particularly in rural areas that may lack pediatric subspecialization. An understanding of the fundamentals can guide appropriate initial management. Additional focus is devoted to the management of genitourinary trauma to guide the general surgeon in more acute, emergent settings.
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Khirallah MG, Elafifi MA, Elbatarny AM, Elsharaby AM. Orchiopexy through a single high transverse scrotal incision. Afr J Paediatr Surg 2015; 12:61-5. [PMID: 25659553 PMCID: PMC4955503 DOI: 10.4103/0189-6725.150986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Palpable Undescended Testis (PUT) represents a common paediatric problem in many premature and some mature infants. There are several surgical techniques to correct PUT either through combined inguinal and scrotal incision or single transverse scrotal incision. This study assessed single high transverse scrotal incision for the management of PUT as regards to feasibility, postoperative success and final cosmetic results. MATERIALS AND METHODS One hundred twenty patients were managed at the Paediatric Surgery Department of Tanta University Hospital with PUT during the period from March 2010 to March 2014. They were all operated at the age of 6-12 months. We excluded recurrent cases, and cases older than 12 months. Through high transverse scrotal incision, the layers were divided, and the canal entered through the external ring, dissecting the PUT and bringing it through the incision. Hernia sac, if present, was ligated at the neck. Creation of the dartos pouch was then made through the same incision. All infants were followed-up at 1 month, 2 months and 6 months to detect any re-ascended cases, testicular atrophy and the final cosmetic appearance. RESULTS A total of 140 PUTs were operated upon in 120 patients. PUT was bilateral in 20 patients, right-sided in 65 cases and left-sided in 35 cases. Thirty testes were located at the external ring; the others were located within the inguinal canal. No cases needed a redo operation, and there was no case of postoperative testicular atrophy. CONCLUSION Single high transverse incision was sufficient to deal with PUT especially, in young infants (age 6 months) with no need for conversion in most cases to the traditional two incisions technique, and good long term follow-up and a better cosmetic results.
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Affiliation(s)
- Mohammad G Khirallah
- Department of Paediatric Surgery, Tanta Faculty of Medicine, Tanta University Hospitals, Tanta, El Gharbeya, Egypt
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Primary new-onset hydroceles presenting in late childhood and pre-adolescent patients resemble the adult type hydrocele pathology. J Pediatr Surg 2014; 49:1656-8. [PMID: 25475813 DOI: 10.1016/j.jpedsurg.2014.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/04/2014] [Accepted: 05/13/2014] [Indexed: 11/22/2022]
Abstract
AIM The aim of this study was to investigate the presence of a patent processus vaginalis (PPV) in children of late childhood and pre-adolescence presenting with new onset hydrocele. MATERIAL AND METHODS All males with hydrocele presenting at our department from January 2011 to January 2013 were followed. Patients with secondary hydroceles were excluded. Demographic data, medical history, clinical symptoms and signs relative to their pathology and U/S findings were recorded. According to their indications, patients were either operated or followed up. Patients surgically treated, consisted our study group. RESULTS Sixty patients were identified. Thirteen were followed until resolution of their hydrocele. Forty-seven patients were surgically treated. Twenty-seven had right sided hydrocele (57.44%), 13 had left sided hydrocele (27.66%) whereas in 7 patients the hydroceles were bilateral (14.9%). All patients were operated by an inguinal approach. In all 9 patients (19.14%) presenting with new-onset hydrocele at the age >10 years (range: 10-15 years), intraoperative exploration did not reveal a PPV. All patients were followed at least for 6 months post-operatively. CONCLUSION Early evidence shows that primary new onset hydroceles presenting in late childhood and pre-adolescence seem to be non-communicating and resemble the adult type hydrocele pathology.
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Alp BF, Irkilata HC, Kibar Y, Zorba U, Sancaktutar AA, Kaya E, Dayanc M. Comparison of the inguinal and scrotal approaches for the treatment of communicating hydrocele in children. Kaohsiung J Med Sci 2013; 30:200-5. [PMID: 24656161 DOI: 10.1016/j.kjms.2013.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022] Open
Abstract
The inguinal approach is used for the treatment of hydrocele in the pediatric population. Although studies on scrotal orchiopexy have mentioned hernia or hydrocele repair through the same scrotal incision as a part of an orchiopexy procedure, there are a few studies reporting the treatment of isolated communicating hydrocele through a scrotal incision. We retrospectively evaluated and compared the outcomes of inguinal and scrotal approaches for the treatment of communicating hydrocele in boys. The classical inguinal and scrotal approaches to the treatment of communicating hydrocele were performed on 46 and 30 testicular units (in 43 boys and 27 boys, respectively). The patients' charts were reviewed to assess the operative times as well as the immediate and long-term complications during follow-up periods. The patients' ages ranged from 1 year to 8 years (3.6 ± 2.0 years) in the inguinal group and from 1 year to 10 years (mean 4.6 ± 2.8 years) in the scrotal group. Operative time was significantly lower in the scrotal group (p < 0.0001). The early minor complication rate did not differ between the two groups. Furthermore, there were no major complications noted. None of the patients had hydrocele recurrence after a mean follow-up of 6 months. The advantages of the scrotal approach for the treatment of communicating hydrocele are as follows: it is well tolerated, simple, and cosmetically appealing, and it has a short operative time in comparison with the standard inguinal approach. The scrotal incision technique is an effective alternative in communicating hydrocele treatment.
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Affiliation(s)
| | | | - Yusuf Kibar
- Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Unal Zorba
- School of Medicine, Rize University, Rize, Turkey
| | | | - Engin Kaya
- Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Murat Dayanc
- Gulhane Military Medical Academy, Etlik, Ankara, Turkey
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Novaes HFF, Carneiro Neto JA, Macedo Jr A, Barroso Junior U. Single scrotal incision orchiopexy - a systematic review. Int Braz J Urol 2013; 39:305-11. [DOI: 10.1590/s1677-5538.ibju.2013.03.02] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/27/2013] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Jose Abraao Carneiro Neto
- Division of Urology Bahiana School of Medicine and Federal University of Bahia and Federal University of Sao Paulo
| | - Antonio Macedo Jr
- Division of Urology Bahiana School of Medicine and Federal University of Bahia and Federal University of Sao Paulo
| | - Ubirajara Barroso Junior
- Division of Urology Bahiana School of Medicine and Federal University of Bahia and Federal University of Sao Paulo
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20 years of transcrotal orchidopexy for undescended testis: results and outcomes. J Pediatr Urol 2010; 6:506-12. [PMID: 19942483 DOI: 10.1016/j.jpurol.2009.10.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 10/22/2009] [Indexed: 11/21/2022]
Abstract
BACKGROUND The role of the transcrotal approach to the undescended testis remains controversial despite its increasing popularity. The authors update their previous published series and review the literature on this subject, aiming to delineate the value of this technique. METHODS The authors performed a retrospective review of the transcrotal primary orchidopexy carried out to treat palpable undescended testis at Royal Manchester Children's Hospital between 1993 and 2005. A structured review of literature published since the proposal of this technique was also performed. RESULTS 122 procedures were included. The transcrotal approach was successfully completed in 119 (97.5%). Additional groin incision was needed in three (2.5%) to further mobilize the spermatic cord. No immediate complications were recorded and 8.4% required a reoperative procedure. On review of the literature, a total of 16 articles were discovered spanning 1695 transcrotal procedures, including the previously published authors' experience. On combining the data, the transcrotal approach required an additional groin incision in 4.4% of cases, 1.6% experienced immediate and/or early complications, and the overall recurrence rate was 2.0%. CONCLUSIONS Transcrotal orchidopexy for the treatment of palpable undescended testes is a safe procedure with a long-term success rate comparable to the two-incision approach.
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