Abstract
Purpose: Infant hydroceles that are communicating by history (fluctuation in size) or examination (reducible fluid) are often repaired soon after presentation. We have followed a series of infant boys with such hydroceles and reviewed their early natural history. Materials and Methods: Since 1998, we have followed 174 infant boys presenting with an apparent communicating hydrocele without immediate surgical repair. All boys were initially seen before 18 months of age and most (168) by 12 months. Most had been full term at delivery, although 32 had been premature (<37 weeks' gestational age) and 11 extremely so (<32 weeks). Most boys (120) had bilateral hydroceles at presentation. Results: Of the 110 boys followed to disposition, 69 (62.7%) had complete resolution without surgery by a mean age of 11.7 months. Forty-one patients (37.3%) underwent surgery for correction at a mean age of 14 months because of persistence in size or development of a hernia. Six developed a hernia during observation, none of whom had any episode of incarceration. Only 2 patients with apparent resolution subsequently had recurrence with a hernia. Age at presentation and gestational age at birth showed no effect on resolution. The hydroceles of 64 boys had improved in size after a mean follow-up of 13.9 months when last seen. Conclusions: Many infant hydroceles that are communicating by history or examination do resolve clinically without surgery and deserve observation. Progression to hernia was rare in our experience and did not result in incarceration. Consequently, little risk is taken by initial observation.
Original language | English (US) |
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Pages (from-to) | 590-593 |
Number of pages | 4 |
Journal | Journal of pediatric surgery |
Volume | 45 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2010 |
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Keywords
- Hernia
- Hydrocele
- Pediatrics
- Scrotal hydrocele
- Urology
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Infant communicating hydroceles-do they need immediate repair or might some clinically resolve? / Koski, Michelle E.; Makari, John H.; Adams, Mark C.; Thomas, John C.; Clark, Peter E.; Pope IV, John C.; Brock, John W.
In: Journal of pediatric surgery, Vol. 45, No. 3, 01.03.2010, p. 590-593.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Infant communicating hydroceles-do they need immediate repair or might some clinically resolve?
AU - Koski, Michelle E.
AU - Makari, John H.
AU - Adams, Mark C.
AU - Thomas, John C.
AU - Clark, Peter E.
AU - Pope IV, John C.
AU - Brock, John W.
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Purpose: Infant hydroceles that are communicating by history (fluctuation in size) or examination (reducible fluid) are often repaired soon after presentation. We have followed a series of infant boys with such hydroceles and reviewed their early natural history. Materials and Methods: Since 1998, we have followed 174 infant boys presenting with an apparent communicating hydrocele without immediate surgical repair. All boys were initially seen before 18 months of age and most (168) by 12 months. Most had been full term at delivery, although 32 had been premature (<37 weeks' gestational age) and 11 extremely so (<32 weeks). Most boys (120) had bilateral hydroceles at presentation. Results: Of the 110 boys followed to disposition, 69 (62.7%) had complete resolution without surgery by a mean age of 11.7 months. Forty-one patients (37.3%) underwent surgery for correction at a mean age of 14 months because of persistence in size or development of a hernia. Six developed a hernia during observation, none of whom had any episode of incarceration. Only 2 patients with apparent resolution subsequently had recurrence with a hernia. Age at presentation and gestational age at birth showed no effect on resolution. The hydroceles of 64 boys had improved in size after a mean follow-up of 13.9 months when last seen. Conclusions: Many infant hydroceles that are communicating by history or examination do resolve clinically without surgery and deserve observation. Progression to hernia was rare in our experience and did not result in incarceration. Consequently, little risk is taken by initial observation.
AB - Purpose: Infant hydroceles that are communicating by history (fluctuation in size) or examination (reducible fluid) are often repaired soon after presentation. We have followed a series of infant boys with such hydroceles and reviewed their early natural history. Materials and Methods: Since 1998, we have followed 174 infant boys presenting with an apparent communicating hydrocele without immediate surgical repair. All boys were initially seen before 18 months of age and most (168) by 12 months. Most had been full term at delivery, although 32 had been premature (<37 weeks' gestational age) and 11 extremely so (<32 weeks). Most boys (120) had bilateral hydroceles at presentation. Results: Of the 110 boys followed to disposition, 69 (62.7%) had complete resolution without surgery by a mean age of 11.7 months. Forty-one patients (37.3%) underwent surgery for correction at a mean age of 14 months because of persistence in size or development of a hernia. Six developed a hernia during observation, none of whom had any episode of incarceration. Only 2 patients with apparent resolution subsequently had recurrence with a hernia. Age at presentation and gestational age at birth showed no effect on resolution. The hydroceles of 64 boys had improved in size after a mean follow-up of 13.9 months when last seen. Conclusions: Many infant hydroceles that are communicating by history or examination do resolve clinically without surgery and deserve observation. Progression to hernia was rare in our experience and did not result in incarceration. Consequently, little risk is taken by initial observation.
KW - Hernia
KW - Hydrocele
KW - Pediatrics
KW - Scrotal hydrocele
KW - Urology
UR - http://www.scopus.com/inward/record.url?scp=77649225568&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77649225568&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2009.06.026
DO - 10.1016/j.jpedsurg.2009.06.026
M3 - Article
C2 - 20223325
AN - SCOPUS:77649225568
VL - 45
SP - 590
EP - 593
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 3
ER -