Trends in treatment outcomes of hydrocele in Japanese children: A single-institute experience.

Abstract

To investigate trends in treatment outcomes of surgical intervention versus observation for pediatric hydrocele. This retrospective study included 175 patients diagnosed with hydrocele at our institution. Hydrocele was diagnosed based on medical history, physical examination and ultrasonography findings. The treatment for these patients was divided into two options: surgical intervention or careful follow up; the outcomes were investigated. The median age at diagnosis was 3months, and a total of 11 patients (6%) were premature at birth. Hydrocele was diagnosed on the right side, the left side and bilaterally in 106 (61%), 46 (26%) and 23 (13%) patients, respectively. A total of 136 patients showed spontaneous improvement at the median 7months after diagnosis, and 54 patients underwent surgical intervention. The rate of spontaneous resolution deceased with age, but spontaneous resolution was observed in patients aged >2years. Our findings suggest that spontaneous resolution can be observed in patients aged >2years, and surgical intervention can be carried out effectively and safely. Infant hydrocele should be followed up carefully for at least 1year without surgical intervention since diagnosis. Investigation of the optimal timing of and appropriate reason for surgical intervention can lead to better management and outcomes in patients with hydrocele. Further research is warranted to support the current clinical practice.