Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Urology (Expert Forum)
Pediatric Hydrocele--Need for Surgery?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Pediatric Hydrocele--Need for Surgery?
by sacrecoeur, Apr 27, 2004 12:00AM
Is there a medical consensus as to whether hydrocele requires operation if it does not resolve by 12 months of age? I have read various medical articles from leading institutions: some say to wait until after 18 months, others 2 years, others 6 years---on the theory that it can still self-resolve or that the child will be better prepared to handle general anesthesia.
My child is now 14 months old. The hydrocele is pain-free, located on the right side and was not noticeable until about 12 months of age. A local pediatric urologist said that he performs surgery immediately after the 12 month marker has passed. I have previously had bad experiences with general anesthesia, and the thought of surgery and general anesthesia for my child scares me.
Is there any possibility of self-resolution past 12 months? In the alternative, is there a less-invasive treatment (such as ultrasound evaluation, aspiration, injection or endoscopy)? If surgery is still recommended, when is the ideal age for surgery? How long can we wait to see if it will resolve? Is surgery recommended for both sides even though the left side evidences no symptoms?
My child is now 14 months old. The hydrocele is pain-free, located on the right side and was not noticeable until about 12 months of age. A local pediatric urologist said that he performs surgery immediately after the 12 month marker has passed. I have previously had bad experiences with general anesthesia, and the thought of surgery and general anesthesia for my child scares me.
Is there any possibility of self-resolution past 12 months? In the alternative, is there a less-invasive treatment (such as ultrasound evaluation, aspiration, injection or endoscopy)? If surgery is still recommended, when is the ideal age for surgery? How long can we wait to see if it will resolve? Is surgery recommended for both sides even though the left side evidences no symptoms?
Doctor's Answer
by Kevin Pho, MD, Apr 28, 2004 12:00AM
, Apr 28, 2004 12:00AM
The management of noncommunicating hydrocele in a neonate or child younger than two years of age is supportive; communicating hydroceles rarely resolve and pose a risk for development of incarcerated inguinal hernia.
Surgical repair is necessary if the child is older than two years of age or the scrotum is tense, which may reduce circulation to the testicles. Appropriate therapy should be provided for the primary condition if one is present (eg, epididymitis, orchitis, testicular torsion, trauma, or tumor).
As to how long you can wait and the specific question of whether to operate on both sides, this is dependent on the patient, and I cannot comment on this without being personally involved in the case.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Brenner et al. Testicular and scrotal masses in children and adolescents. UptoDate, 2004.
Surgical repair is necessary if the child is older than two years of age or the scrotum is tense, which may reduce circulation to the testicles. Appropriate therapy should be provided for the primary condition if one is present (eg, epididymitis, orchitis, testicular torsion, trauma, or tumor).
As to how long you can wait and the specific question of whether to operate on both sides, this is dependent on the patient, and I cannot comment on this without being personally involved in the case.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Brenner et al. Testicular and scrotal masses in children and adolescents. UptoDate, 2004.
