Infantile Abdominoscrotal Hydrocele: A Not So Benign Condition

Main Category: Urology / Nephrology
Article Date: 11 Feb 2009 - 1:00 PDT

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UroToday.com - In a recent article in the Journal of Urology, Dr. Denis Cozzi et al. reported their experience with abdominoscrotal hydroceles. A retrospective review of all their infant cases treated over a 10-year period showed that they had 18 patients who underwent abdominoscrotal hydrocele repairs. They found that the condition was very difficult to treat. They tried both a scrotal and an inguinal approach and found that the scrotal approach was easier and with the same results. An editorial comment by Dr. Belman reiterates that the scrotal approach is simpler and easier. He also finds it to be superior as well.

It has been our experience at The Children's Hospital of Philadelphia as well that the scrotal approach to these abdominoscrotal hydroceles is simpler with less morbidity to the patient. We make a scrotal incision, drain the hydrocele, and then place a Penrose drain which is removed after about one week. All the children have done well. I also agree with Dr. Belman that imaging studies are not indicated, as this entity is readily and easily made by physical examination. The bimanual examination shows that the enlargement of the scrotum is compressible into the abdominal cavity and one can feel the abdominal bulge above the internal inguinal ring. I would caution surgeons to truly embrace the scrotal approach to these abdominoscrotal hydroceles. It works great and it is easy on the patients.

Cozzi DA, Mele E, Ceccanti S, Pepino D, d'Ambrosio G, Cozzi F
J Urol. 2008 Dec;180(6):2611-5
doi:10.1016/j.juro.2008.08.054

Written by UroToday.com Medical Editor Pasquale Casale, MD

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