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A prospective study of neonatal inguinal herniotomy: the problem of the postoperative hydrocele
Previous studies have reported an increased incidence of complications following neonatal inguinal herniotomy (IH) in boys. The incidence and natural history of postoperative hydrocele in such cases has not been described. A prospective follow-up study of a consecutive series of male infants weighin...
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Published in: | Pediatric surgery international 2003-04, Vol.19 (1-2), p.68-70 |
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description | Previous studies have reported an increased incidence of complications following neonatal inguinal herniotomy (IH) in boys. The incidence and natural history of postoperative hydrocele in such cases has not been described. A prospective follow-up study of a consecutive series of male infants weighing less than 3 kg at the time of IH was undertaken. Regular follow-up examinations were scheduled for at least 1 year. Thirty-eight boys weighing less than 3 kg underwent IH during an 18-month period. One subsequently died from complications of prematurity. Complete follow-up data were available for 29/37 (78%) patients, yielding a total of 46 IHs. There were 2 recurrent hernias (4%), 2 unequivocally atrophic testes (4%), and 1 iatrogenic testicular ascent (2%). Five ipsilateral hydroceles complicated the postoperative course of 4 boys (14% of patients, 11% of herniotomies). Two of these were explored, but in neither case was a recurrent/residual patent processus vaginalis found. One hydrocele was aspirated without recurrence, and the remaining 2 resolved spontaneously. The complication rate in small infants undergoing neonatal IH is significantly higher than in older boys. The presence of a hydrocele after neonatal IH may simply reflect the accumulation of fluid in the distal hernia sac and, provided there is no evidence of a recurrent inguinal hernia, an expectant approach is recommended. |
doi_str_mv | 10.1007/s00383-002-0805-4 |
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Roly ; CRABBE, David C. G ; STRINGER, Mark D</creator><creatorcontrib>DAVIES, Brian W ; FRASER, Nia ; NAJMALDIN, Azad S ; SQUIRE, B. Roly ; CRABBE, David C. G ; STRINGER, Mark D</creatorcontrib><description>Previous studies have reported an increased incidence of complications following neonatal inguinal herniotomy (IH) in boys. The incidence and natural history of postoperative hydrocele in such cases has not been described. A prospective follow-up study of a consecutive series of male infants weighing less than 3 kg at the time of IH was undertaken. Regular follow-up examinations were scheduled for at least 1 year. Thirty-eight boys weighing less than 3 kg underwent IH during an 18-month period. One subsequently died from complications of prematurity. Complete follow-up data were available for 29/37 (78%) patients, yielding a total of 46 IHs. There were 2 recurrent hernias (4%), 2 unequivocally atrophic testes (4%), and 1 iatrogenic testicular ascent (2%). Five ipsilateral hydroceles complicated the postoperative course of 4 boys (14% of patients, 11% of herniotomies). Two of these were explored, but in neither case was a recurrent/residual patent processus vaginalis found. One hydrocele was aspirated without recurrence, and the remaining 2 resolved spontaneously. The complication rate in small infants undergoing neonatal IH is significantly higher than in older boys. The presence of a hydrocele after neonatal IH may simply reflect the accumulation of fluid in the distal hernia sac and, provided there is no evidence of a recurrent inguinal hernia, an expectant approach is recommended.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-002-0805-4</identifier><identifier>PMID: 12721728</identifier><identifier>CODEN: PSUIED</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Abdomen ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Hernia, Inguinal - congenital ; Hernia, Inguinal - surgery ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive care medicine ; Male ; Medical sciences ; Other diseases. 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Roly</creatorcontrib><creatorcontrib>CRABBE, David C. G</creatorcontrib><creatorcontrib>STRINGER, Mark D</creatorcontrib><title>A prospective study of neonatal inguinal herniotomy: the problem of the postoperative hydrocele</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><description>Previous studies have reported an increased incidence of complications following neonatal inguinal herniotomy (IH) in boys. The incidence and natural history of postoperative hydrocele in such cases has not been described. A prospective follow-up study of a consecutive series of male infants weighing less than 3 kg at the time of IH was undertaken. Regular follow-up examinations were scheduled for at least 1 year. Thirty-eight boys weighing less than 3 kg underwent IH during an 18-month period. One subsequently died from complications of prematurity. Complete follow-up data were available for 29/37 (78%) patients, yielding a total of 46 IHs. There were 2 recurrent hernias (4%), 2 unequivocally atrophic testes (4%), and 1 iatrogenic testicular ascent (2%). Five ipsilateral hydroceles complicated the postoperative course of 4 boys (14% of patients, 11% of herniotomies). Two of these were explored, but in neither case was a recurrent/residual patent processus vaginalis found. One hydrocele was aspirated without recurrence, and the remaining 2 resolved spontaneously. The complication rate in small infants undergoing neonatal IH is significantly higher than in older boys. The presence of a hydrocele after neonatal IH may simply reflect the accumulation of fluid in the distal hernia sac and, provided there is no evidence of a recurrent inguinal hernia, an expectant approach is recommended.</description><subject>Abdomen</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hernia, Inguinal - congenital</subject><subject>Hernia, Inguinal - surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. 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Roly ; CRABBE, David C. G ; STRINGER, Mark D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-e92f632f935b3622b249fde4a09b3dae084f940068d6780242f0d4ba40ea2fd03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Abdomen</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hernia, Inguinal - congenital</topic><topic>Hernia, Inguinal - surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Testicular Hydrocele - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DAVIES, Brian W</creatorcontrib><creatorcontrib>FRASER, Nia</creatorcontrib><creatorcontrib>NAJMALDIN, Azad S</creatorcontrib><creatorcontrib>SQUIRE, B. Roly</creatorcontrib><creatorcontrib>CRABBE, David C. 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Roly</au><au>CRABBE, David C. G</au><au>STRINGER, Mark D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective study of neonatal inguinal herniotomy: the problem of the postoperative hydrocele</atitle><jtitle>Pediatric surgery international</jtitle><addtitle>Pediatr Surg Int</addtitle><date>2003-04-01</date><risdate>2003</risdate><volume>19</volume><issue>1-2</issue><spage>68</spage><epage>70</epage><pages>68-70</pages><issn>0179-0358</issn><eissn>1437-9813</eissn><coden>PSUIED</coden><abstract>Previous studies have reported an increased incidence of complications following neonatal inguinal herniotomy (IH) in boys. The incidence and natural history of postoperative hydrocele in such cases has not been described. A prospective follow-up study of a consecutive series of male infants weighing less than 3 kg at the time of IH was undertaken. Regular follow-up examinations were scheduled for at least 1 year. Thirty-eight boys weighing less than 3 kg underwent IH during an 18-month period. One subsequently died from complications of prematurity. Complete follow-up data were available for 29/37 (78%) patients, yielding a total of 46 IHs. There were 2 recurrent hernias (4%), 2 unequivocally atrophic testes (4%), and 1 iatrogenic testicular ascent (2%). Five ipsilateral hydroceles complicated the postoperative course of 4 boys (14% of patients, 11% of herniotomies). Two of these were explored, but in neither case was a recurrent/residual patent processus vaginalis found. One hydrocele was aspirated without recurrence, and the remaining 2 resolved spontaneously. The complication rate in small infants undergoing neonatal IH is significantly higher than in older boys. The presence of a hydrocele after neonatal IH may simply reflect the accumulation of fluid in the distal hernia sac and, provided there is no evidence of a recurrent inguinal hernia, an expectant approach is recommended.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>12721728</pmid><doi>10.1007/s00383-002-0805-4</doi><tpages>3</tpages></addata></record> |
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subjects | Abdomen Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Emergency and intensive care: neonates and children. Prematurity. Sudden death Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Hernia, Inguinal - congenital Hernia, Inguinal - surgery Humans Incidence Infant Infant, Newborn Intensive care medicine Male Medical sciences Other diseases. Semiology Postoperative Complications - epidemiology Prospective Studies Testicular Hydrocele - epidemiology Treatment Outcome |
title | A prospective study of neonatal inguinal herniotomy: the problem of the postoperative hydrocele |
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