Hydrocele of the Spermatic Cord in Infants and Children: Its Particular Characteristics

BACKGROUND The hydrocele of the spermatic cord (cord hydrocele) typically presents as a translucent swelling in the inguinal canal or upper scrotum, located above the testis. We report a case series and point out its distinctive characteristics. METHODS From May 2008 to October 2009, 20 consecutive male infants or boys, ranging in age from 38 days to 54 months (mean age, 29.4 months), with cord hydrocele previously treated at our institution were retrospectively reviewed. There were 10 right and 10 left cord hydroceles. Surgery for 16 irreducible cord hydroceles was done via the open approach, whereas the remaining 4 were reducible and laparoscopy was performed. RESULTS Five cord hydroceles were of encysted variety, and 7 were of funicular variety. The remaining 8 hydroceles, called mixed variety by the authors, had solitary or more than 1 wall-integrated cyst, but the proximal processus vaginalis remained patent. Of 4 patients with reducible cord hydrocele, 3 were of mixed variety and the remaining 1 was of funicular variety. Whether age and the hydrocele presented as reducible was similar among the 3 varieties (P = .099 and 0.232, respectively). CONCLUSIONS Because the processus vaginalis remained patent in mixed variety, herniotomy is required to prevent later occurrence of an inguinal hernia. Laparoscopy may be an alternative therapeutic tool in patients with reducible funicular or mixed varieties. UROLOGY 76: 82-86, 2010. (C) 2010 Elsevier Inc.