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22.07.2020 | Original Article

The outcomes of conservative management and the natural history of asymptomatic hydroceles in children

verfasst von: Masashi Kurobe, Atsushi Harada, Tetsuro Sugihara, Yuji Baba, Tomomasa Hiramatsu, Shinsuke Ohashi, Masahiko Otsuka

Erschienen in: Pediatric Surgery International | Ausgabe 10/2020

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Abstract

Purpose

To elucidate the natural history of asymptomatic hydroceles (AHs) in children with conservative management and to discuss management strategies for AHs in children.

Methods

We retrospectively reviewed 113 children with AHs who were followed without immediate surgery. Patients were divided into four groups according to age at presentation; group 1: ≤ 1 month, group 2: 1–12 months, group 3: 12–24 months, and group 4: > 24 months. Ages at spontaneous resolution or surgery were reviewed. To assess the effect of AH on the testis, testicular size before and after conservative management was compared in 11 cases.

Results

In groups 1, 2, 3, and 4, spontaneous resolution occurred in 94.3%, 75.0%, 65.0%, and 33.3%, and the average time to resolution from presentation was 5, 5, 17, and 9 months, respectively. 41 patients underwent surgery at a mean age of 4.2 years. The testicular size did not differ significantly between before and after conservative management (14.4 vs. 14.5 mm, p = 0.483).

Conclusion

About one-third of children over 2 years of age achieve spontaneous resolution. Hydroceles with conservative management may not affect the testicular size. Thus, initial conservative management before surgery is recommend for AHs in children, even over 2 years of age.

Palmer LS, Palmer JS (2016) Management of abnormalities of the external genitalia in boys. In: Wein AJ (ed) Campbell-Walsh urology, 11th edn. Elsevier, Philadelphia, pp 3368–3398

Kapur P, Caty MG, Glick PL (1998) Pediatric hernias and hydroceles. Pediatr Clin North Am 45:773–789. https://doi.org/10.1016/S0031-3955(05)70044-4CrossRefPubMed

Radmayr C, Bogaert G, Dogan HS, Ko˘cvara R, Nijman JM, Stein R et al (2019) Hydrocele. Guidelines on paediatric urology. Eur Societ Paediatr Urol, European Association of Urology, pp 17–18

Lau ST, Lee YH, Caty MG (2008) Current management of hernias and hydroceles. Semin Pediatr Surg 16:50–57. https://doi.org/10.1053/j.sempedsurg.2006.10.007CrossRef

Glick PL, Boulanger SC (2012) Inguinal Hernias and Hydroceles. In: Coran AG (ed) Pediatric surgery, 7th edn. Elsevier, Philadelphia, pp 985–1001CrossRef

Dandapat MC, Padhi NC, Patra AP (1990) Effect of hydrocele on testis and spermatogenesis. Br J Surg 77:1293–1294. https://doi.org/10.1002/bjs.1800771132CrossRefPubMed

Sakamoto H, Ogawa Y, Yoshida H (2008) Relationship between testicular volume and testicular function: comparison of the Prader orchidometric and ultrasonographic measurements in patients with infertility. Asian J Androl 10:319–324. https://doi.org/10.1111/j.1745-7262.2008.00340.xCrossRefPubMed

Osifo OD, Osaigbovo EO (2008) Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City. Nigeria J Pediatr Urol 4:178–182. https://doi.org/10.1016/j.jpurol.2007.12.006CrossRefPubMed

Christensen T, Cartwright PC, Devries C, Snow BW (2006) New onset of hydroceles in boys over 1 year of age. Int J Urol 13:1425–1427. https://doi.org/10.1111/j.1442-2042.2006.01583.xCrossRefPubMed

10.

Acer-Demir T, Ekenci BY, Özer D, Turanoğlu MA, Haberal KC, Bilgin EB et al (2018) Natural history and conservative treatment outcomes for hydroceles: a retrospective review of one center's experience. Urology 112:155–160. https://doi.org/10.1016/j.urology.2017.10.003CrossRefPubMed

11.

Wiener ES, Touloukian RJ, Rodgers BM, Grosfeld JL, Smith EI, Ziegler MM et al (1996) Hernia survey of the section on surgery of the american academy of pediatrics. J Pediatr Surg 31:1166–1169. https://doi.org/10.1016/S0022-3468(96)90110-4CrossRefPubMed

12.

Antonoff MB, Kreykes NS, Saltzman DA, Acton RD (2005) American academy of pediatrics section on surgery hernia survey revisited. J Pediatr Surg 40:1009–1014. https://doi.org/10.1016/j.jpedsurg.2005.03.018CrossRefPubMed

13.

Hall NJ, Ron O, Eaton S, Pierro A (2011) Surgery for hydrocele in children-an avoidable excess? J Pediatr Surg. 46:2401–2405. https://doi.org/10.1016/j.jpedsurg.2011.07.029CrossRefPubMed

14.

Jobson M, Hall NJ (2017) Current practice regarding timing of patent processus vaginalis ligation for idiopathic hydrocele in young boys: a survey of UK surgeons. Pediatr Surg Int 33:677–681. https://doi.org/10.1007/s00383-017-4085-4CrossRefPubMedPubMedCentral

15.

Politoff L, Hadziselimovic F, Herzog B, Jenni P (1990) Does hydrocele affect later fertility? Fertil Steril 53:700–703. https://doi.org/10.1016/S0015-0282(16)53467-0CrossRefPubMed

16.

Tanyel FC, Ocal T, Büyükpamukçu N (2001) Excessive sac pressures: the pathogenesis and innocence of hydroceles in children. BJU Int 87:372–375. https://doi.org/10.1046/j.1464-410x.2001.00076.xCrossRefPubMed

17.

Józsa T, Telek A, Kutasy B, Benyó M, Csanádi G, Kovács I et al (2009) Effect of hydrocele on appendix testis in children. Asian J Androl. 11:741–745. https://doi.org/10.1038/aja.2009.54CrossRefPubMedPubMedCentral

18.

Asanuma H, Iwamura Y, Kakizaki H, Ikuno T, Tohda A, Hayashi Y et al (2005) Undescended testis/cryptorchidism treatment guideline. Jpn J Pediatr Urol 2:117–151 (in Japanese)

19.

Condorelli RA, Cannarella R, Calogero AE, Vignera SL (2018) Evaluation of testicular function in prepubertal children. Endocrine 62:274–280. https://doi.org/10.1007/s12020-018-1670-9CrossRefPubMed

20.

Matuszczak E, Hermanowicz A, Debek W, Oksiuta M, Dzienis-Koronkiewicz E, Zelazowska-Rutkowska B (2012) Serum AMH concentration as a marker evaluating gonadal function in boys operated on for unilateral cryptorchidism between 1st and 4th year of life. Endocrine 41:334–337. https://doi.org/10.1007/s12020-011-9551-5CrossRefPubMed

21.

Edelsztein NY, Grinspon RP, Schteingart HF, Rey RA (2016) Anti-Müllerian hormone as a marker of steroid and gonadotropin action in the testis of children and adolescents with disorders of the gonadal axis. Int J Pediatr Endocrinol. https://doi.org/10.1186/s13633-016-0038-2CrossRefPubMedPubMedCentral

Titel: The outcomes of conservative management and the natural history of asymptomatic hydroceles in children
verfasst von: Masashi Kurobe
Atsushi Harada
Tetsuro Sugihara
Yuji Baba
Tomomasa Hiramatsu
Shinsuke Ohashi
Masahiko Otsuka
Publikationsdatum: 22.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 10/2020
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04720-1

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The outcomes of conservative management and the natural history of asymptomatic hydroceles in children