Infant communicating hydroceles-do they need immediate repair or might some clinically resolve?

Michelle E. Koski, John H. Makari, Mark C. Adams, John C. Thomas, Peter E. Clark, John C. Pope IV, John W. Brock

Research output: Contribution to journal › Article

28 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)590-593
Number of pages4
JournalJournal of pediatric surgery
Volume45
Issue number3
DOIs
StatePublished - Mar 1 2010

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Hernia
Observation
Gestational Age
History
Natural History
Parturition
Recurrence

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

Koski, ME, Makari, JH, Adams, MC, Thomas, JC, Clark, PE, Pope IV, JC & Brock, JW 2010, 'Infant communicating hydroceles-do they need immediate repair or might some clinically resolve?', Journal of pediatric surgery, vol. 45, no. 3, pp. 590-593. https://doi.org/10.1016/j.jpedsurg.2009.06.026
Koski ME, Makari JH, Adams MC, Thomas JC, Clark PE, Pope IV JC et al. Infant communicating hydroceles-do they need immediate repair or might some clinically resolve? Journal of pediatric surgery. 2010 Mar 1;45(3):590-593. https://doi.org/10.1016/j.jpedsurg.2009.06.026
Koski, Michelle E. ; Makari, John H. ; Adams, Mark C. ; Thomas, John C. ; Clark, Peter E. ; Pope IV, John C. ; Brock, John W. / Infant communicating hydroceles-do they need immediate repair or might some clinically resolve?. In: Journal of pediatric surgery. 2010 ; Vol. 45, No. 3. pp. 590-593.
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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.

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