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Abstract
Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of debate. The aim of the present study was to investigate the incidence of contralateral patent processus vaginalis (CPPV) using transinguinal laparoscopy (inguinoscopy). In addition, the risk factors of CPPV were evaluated in order to facilitate the selection of appropriate candidates for contralateral examination. A total of 119 patients who presented with unilateral hydrocele, inguinal hernia or cryptorchidism between 2001 and 2008 underwent inguinoscopy during the ipsilateral surgery. All data were collected prospectively. The incidence of CPPV was investigated and the risk factors affecting the presence of CPPV were analyzed. Among these patients, 29 individuals (24.4%) had CPPV confirmed by inguinoscopy. No surgical complications were observed during the inguinoscopy. Cases with suspicious ultrasound findings were at a higher risk of CPPV than cases with normal findings (odds ratio, 13.800; P=0.004). A history of contralateral disease was also found to be a significant risk factor (odds ratio, 4.008; P=0.019). The present study identified that the significant risk factors for CPPV were suspicious findings on ultrasound examination and a history of contralateral disease. Therefore, it is concluded that performing inguinoscopy in children with these risk factors is beneficial.
Highlights
Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of considerable debate
The case records were reviewed for each patient and the variables evaluated included age at surgery; the side affected by LEE et al: RISK FACTORS FOR CONTRALATERAL PATENT PROCESSUS VAGINALIS
To define the risk factors for contralateral patent processus vaginalis (CPPV), the presence of the following was assessed: i) previous history of contralateral hydrocele or hernia, which meant that the patient had presented with contralateral hydrocele or hernia in the past but did not have clinical contralateral disease at the time of the surgery; ii) suspicion of contralateral hydrocele on physical examination, which meant the patient did not have contralateral disease clinically but had scanty fluid or sac‐like materials within the scrotum on palpation; and iii) findings suspicious for contralateral hydrocele on ultrasound
Summary
Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of considerable debate. It is widely considered that contralateral groin exploration is not justified in children with unilateral disease due to the low incidence of contralateral hernia and the potential for operative complications
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