Contralateral Occurrence after Unilateral Repair of Hydrocele in Children

Nam, Bong Hyeon; Lee, Dong Hwan

Abstract

PURPOSE: Retrospective studies were carried out to clarify the incidence of contralateral occurrence after unilateral repair of hydrocele in children and the role of ultrasonography in preoperative recognition of asymptomatic hydrocele.
MATERIALS AND METHODS
452 patients of under 14 years old who underwent unilateral hydrocele repairs between January, 1990 and December, 1997 were reviewed. Patients with contralateral occurrence were defined as those who had previous unilateral hydrocele repairs and no clinical or historical evidence of contralateral hydrocele at the time of the initial repair Patients with simultaneous presence of bilateral hydrocele on their initial visit were excluded from this study. 36 patients who visited lately underwent ultrasonographic examination of both side of the groin and scrotum prior to surgery to identify asymptomatic contralateral hydrocele.
RESULTS
The incidence of contralateral occurrence after unilateral hydrocele repairs was 5.4%(24 patients). When the left side was repaired initially, 13(7.4%) patients showed contralateral occurrence and when the right side was repaired initially, 11 (4.0%) patients showed contralateral occurrence. In the 36 patients who underwent ultrasonography, 2 patients(5.6%) had asymptomatic contralateral hydrocele and exploration revealed the presence of a patent processus vaginalis. On the other hand, 2 patients(5.6%) with negative ultrasonographic findings had contralateral repairs 1 month after clinically apparent hydrocele repair.
CONCLUSIONS
Although the incidence was low, contralateral occurrence after unilateral repair of hydrocele in children was noted. Therefore, preoperative thorough history taking and physical examination in unilateral hydrocele patients should be performed. Also, in suspicious cases, inguinal or scrotal ultrasonography is helpful for the detection of the clinically occult contralateral hydrocele in children.