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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
Main Authors: DAVIES, Brian W, FRASER, Nia, NAJMALDIN, Azad S, SQUIRE, B. Roly, CRABBE, David C. G, STRINGER, Mark D
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container_title Pediatric surgery international
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FRASER, Nia
NAJMALDIN, Azad S
SQUIRE, B. Roly
CRABBE, David C. G
STRINGER, Mark D
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.
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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. 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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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