Hydrocele In Children Research Articles

Traditional Inguinal Incision and High Scrotal Incision (Bianchi) in Management of Encysted hydrocele in children- a Comparative Study

Traditional Inguinal Incision and High Scrotal Incision (Bianchi) in Management of Encysted hydrocele in children- a Comparative Study

Comparison of Percutaneous Internal Ring Suturing (PIRS) versus Open Ligation of the Patent Processus Vaginalis for the Treatment of Communicating Pediatric Hydrocele.

Although the laparoscopic approach become standard for the treatment of many surgical conditions many studies still debating whether laparoscopic surgery has significant advantages over open surgery in regards to hernia or hydrocele treatment. This study aimed to evaluate the outcomes of treatment of treatment of communicating hydrocele in pediatric patients between laparoscopic percutaneous internal ring suturing (PIRS) and open ligation of the patent processus vaginalis (PPV). The medical records of pediatric patients who underwent surgery for communicating hydrocele between 1 January 2019 and 1 January 2024 were retrospectively reviewed. The primary objective of the study is to investigate the outcomes of treatment (complications and recurrence rates) of communicating hydrocele in children between laparoscopic and open surgical approaches. Secondary outcomes of the study are the duration of surgery and anesthesia, length of hospital stay (LOS), frequency of hospital readmissions (ReAd) and unplanned return to the operating room (uROR). A total of 198 children underwent surgery for a communicating hydrocele (205 repairs, as 7 cases were bilateral) and were included in the study. Of these, 87 children underwent a PIRS, while the remaining 111 cases underwent open ligation of the PPV. No recurrence of the hydrocele was observed in any of the study groups. Intraoperative complication (epigastric vein injury) was noted in two cases in both groups (2.3% vs. 1.8%, p > 0.999). A slightly higher number of postoperative complications was observed in the open group (n = 7, 6.3%) compared to the PIRS group (n = 2, 2.3%) (p = 0.190). The median duration of surgery (15 min (IQR 10, 17) vs. 21 min (IQR 15, 25); p < 0.001) and anesthesia (30 min (IQR 25, 40) vs. 40 min (IQR 35, 40); p < 0.001) were significantly lower in the PIRS group compared to open ligation of the PPV. In addition, a significantly shorter median of LOS was observed in the PIRS group compared to the open PPV group (9 h (IQR 8, 12) vs. 24 h (IQR 12, 24; p < 0.001). No cases of ReAd and uROR were observed in any of the study groups. PIRS is a safe and effective laparoscopic technique that can be used in the treatment of communicating hydrocele in children. PIRS showed excellent outcomes and a low incidence of complications and recurrences, comparable to traditional open surgery.

Comparison of the results of open repair and laparoscopic repair with the PIRS method in the treatment of hydrocele in children.

Hydrocele is a result of intraperitoneal fluid filling into the scrotum through the patent processus vaginalis (PPV). While the traditional approach of pediatric hydrocele has been open repair (OR) for years, laparoscopic repair (LR) of hydrocele has been accepted worldwide after the proven efficacy of laparoscopy. The purpose is to compare the outcomes of both techniques in a single center. We retrospectively analyzed the clinical data of all the patients who underwent hydrocele repair from August 2016 to November 2022. In our center, the standard approach was OR in hydrocele until the November of 2021. Starting from this date, LR has begun to be preferred, as the experience has increased and its success has been observed. In the LR group, single-port percutaneous internal ring suturing technique was performed. The data of 113 patients (OR 58.4% (n = 66), LR 41.6% (n = 47)) were collected. In preoperative examination, 12.4% (n = 14) patients were diagnosed as communicating and 87.6% (n = 99) non-communicating hydrocele. Intraoperatively, 65.5% (n = 74) patients were communicating and 34.5% (n = 39) were non-communicating. Total recurrence rate was 7% (n = 8). The OR group experienced a recurrence rate of 10.6% (n = 7), while the LR group experienced 2.12% (n = 1). Laparoscopy may reveal intrabdominal connection of hydrocele better than open approach. It provides a high quality view of both inguinal rings and has the advantages of minimally invasive surgery.

Dose Hydrocele in Children Caused by Ventriculoperitoneal Shunt Migration Always Need Surgical Intervention? Watch and Wait - A Rare Cause of Hydrocele

Introduction: Ventriculoperitoneal (V-P) shunt is a common surgery for pediatric patients with hydrocephalus. Migration of the shunt to the scrotum is rare. Its clinical presentation may be silent if the shunt keeps patent. We describe such a case following the implantation of a V-P shunt with scrotal migration, with the tip still kept in the peritoneal cavity with patent function. We will discuss this rare complication and review the literature. Case Presentation: A 28-week-old boy presented preterm-related spontaneous intraventricular hemorrhage and hydrocephalus. The patient underwent surgery via V-P shunt implantation. One month after the operation, V-P shunt migration with the right hydrocele was diagnosed while the tip was still in the peritoneal cavity with a patent function. We adopted a watch-and-wait approach in which outpatient follow-up would be continued until the patient was 1.5 years old, when we would decide whether to perform hydrocele repair and correct the drainage tube malposition or continue follow-up. The patient was alert with good activity and close follow-up. Conclusions: Ventriculoperitoneal shunt migration with hydrocele in young children is a rare complication after the surgery. Regular follow-up up to 1.5 years old is recommended for patients with the tip in the peritoneal cavity and patent shunt function. Surgical intervention is suggested for cases with tip in the scrotum, shunt kinking, remarkable hydrocele, or hydrocephalus progression. Although V-P shunt migration is uncommon, we should take care of it to find out and solve the problem.

A study of clinical analysis and management of lnguinoscrotal swelling in paediatric age group

Background: Inguinoscrotal swellings are one of the commonest congenital problems in infancy and childhood. Delay in diagnosis and treatment leads to loss of testis, ovaries or portion of bowel to incarceration or strangulation. This study was undertaken for clinical evaluation of age, sex, sidewise distribution management and management of complications.Methods: Retrospective observational study done from April 2011 to March 2019. Children with age from 1 month to 12 years presenting with inguinoscrotal swelling Results: In Total 174 children had inguinoscrotal swelling which include 155 (89%) male children and 19 (11%) female children. Most of the patients presented in 2 to 5 years (41%) age group out of 114 case of inguinal hernia include 63 on right,47 on left and 4 bilateral and 60 case of hydrocele 48 on right,10 on left and 2 bilateral.0ut of 174 children 16 were discharge on same day of surgery. Out of 174 children 1 patient had taken as emergency operation due to irreducible hernia. Conclusions: Inguinal hernia and hydrocele in children remain one of the most common congenital problems observed by surgeons. The childhood inguinoscrotal swellings are generally more predominant on the right side and this has been attributed to the delay in descent of the right testis. Regarding the sex prevalence, males are more commonly affected. Inguinal herniotomy in children is a safe and effective operation done as day care procedure.

Comparative Study between Scrotal and Inguinal Approach for Repair of Communicating Hydrocele in Children

Comparative Study between Scrotal and Inguinal Approach for Repair of Communicating Hydrocele in Children

Could increased expression of aquaporin-1 be an etiological cause in childhood noncommunicating hydroceles that do not regress spontaneously?

Aquaporins are membrane water channel proteins that are expressed in the epithelium and endothelium. Their primary function is to control the flow of water in the membranes of the cells. In this study, we investigated whether there is increased expression of aquaporin-1 in the tunica vaginalis of hydrocele patients in childhood that do not regress spontaneously an whether it has an effect on the etiology of hydrocele. Boys who were diagnosed with hydrocele and scheduled for surgery were included and formed the hydrocele group. Boys in the same age range who underwent surgery for inguinal hernia or undescended testicles were included as a control group. Aquaporin-1 expression was evaluated by immunohistochemical examination of capillaries in tissue samples taken from the tunica vaginalis during the operation. Aquaporin-1-positive vessels were counted by selecting 5 unrelated areas with the highest vascular density, and the average number of vessels was calculated for each case. A total of 48 male patients were included in the study. Of these, 27 constituted the hydrocele group (mean age 3.51±2.59 years), and 21 constituted the control group (inguinal hernia, n=17; undescended testicle, n=4) (mean age 3.95±3.80 years). The mean ages of both groups were statistically similar (p=0.32). The mean numbers of aquaporin-1-positive vessels at the capillaries in the tunica vaginalis of the patients were 20.74±7.10 in hydrocele group and 17.23±4.07 in the control group. The expression of aquaporin-1 in the hydrocele group was significantly higher (p=0.037). It was shown that aquaporin-1 expression was higher in adult cases with hydrocele. Also an increase in aquaporin-1 expression was detected in tunica vaginalis of children with hydrocele in our study. It was thought that aquaporin-1 overexpression may play a role in non-communicating hydroceles in children.

Laparoscopic vs. Open Repair Surgery for the Treatment of Communicating Hydrocele in Children: A Retrospective Study From a Single Center.

Purpose: This study evaluated the outcomes of laparoscopic repair (LR) and open repair (OR) surgery for communicating hydrocele in children.Patients and Methods: We collected the clinical data and follow-up data of all boys (<14 years) who underwent communicating hydrocele surgery in the pediatric surgery department at Yijishan Hospital of Wannan Medical College from January 2017 to December 2018 and retrospectively analyzed the data.Results: In this study, 155 patients were retrospectively enrolled, including 90 patients in the OR group and 65 patients in the LR group. There were significant differences in operation time and the recurrence of hydrocele between the two groups. The persistence of scrotal swelling in the LR group was significantly lower than that in the OR group. There was no significant difference in postoperative hospitalization time or incision infection rate between the two groups.Conclusion: In conclusion, this study shows that laparoscopic treatment of children with communicating hydrocele has the advantages of a hidden incision, a shortened operation time, and a reduced postoperative recurrence rate and can be used as the preferred surgical method. However, laparoscopic treatment should be selected according to the specific condition of each child and cannot completely replace traditional open surgery.

Comparison of Open Repair and Laparoscopic Percutaneous Internal Ring Suturing Method in Repairing Inguinal Hernia in Children.

IntroductionAn inguinal indirect hernia is one of the most frequent surgical conditions in children. In this study the experience with laparoscopic percutaneous internal ring suturing (PIRS) and open inguinal hernia surgery and their relations evaluated.MethodsAll children over 90 days of age and without having prior inguinal region surgery with a diagnosis of indirect inguinal hernia underwent surgical repair with open or laparoscopic PIRS technique. Patients' gender, age at surgery, inguinal hernias side, surgery duration, recurrence, complications, and follow-ups were collected.ResultsA total of 488 inguinal hernias of 405 patients were repaired. The diagnoses were unilateral inguinal hernia in 360 (88.9%) and it was bilateral in 33 (8.1%) patients. The operative technique was laparoscopic PIRS for 227 and open inguinal hernia surgery for 178 patients. In the PIRS group, a contralateral hernia was found in 48 of 205 children (23.4%). The surgery times were 23.3 (PIRS) and 33.7 (open) min for unilateral and 28 (PIRS) and 53.1 (open) min on average for bilateral inguinal hernia surgery. Mean follow-up was 30.4 months for PIRS and 24.4 months for open technique. Recurrence was observed in seven (3%) patients in PIRS and one (0.5%) in the open group and postoperative complications in three (1.3%) in PIRS and four (2.2%) in the open group.ConclusionPIRS method has the advantage to evaluate contralateral hernia at the same session, minimal scar related to surgery, and preserve the spermatic cord from manipulation. PIRS is an alternative feasible method and easy to perform to repair the inguinal hernia with/without communicating hydrocele in children.

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

To elucidate the natural history of asymptomatic hydroceles (AHs) in children with conservative management and to discuss management strategies for AHs in children. 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: ≤ 1month, group 2: 1-12months, group 3: 12-24months, and group 4: > 24months. 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. 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 9months, respectively. 41 patients underwent surgery at a mean age of 4.2years. The testicular size did not differ significantly between before and after conservative management (14.4 vs. 14.5mm, p = 0.483). About one-third of children over 2years 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 2years of age.

Scrotal Ultrasound Is Not Routinely Indicated in the Management of Cryptorchidism, Retractile Testes, and Hydrocele in Children.

Cryptorchidism, or undescended testes, is the most common congenital genitourinary anomaly. A failure or delay of treatment may result in reduced fertility or an increased risk of testicular cancer. The American Urological Association (AUA) recommends that a scrotal ultrasound (SUS) not be performed in the preoperative management of cryptorchidism. This study investigated how likely pediatricians were to perform SUS despite the AUA guidelines. We retrospectively studied 243 patients referred to a single pediatric urology practice for clinically diagnosed testis pathology including undescended testis, hydrocele, and retractile testis over a 4-year period (January 1, 2015, to December 30, 2018). A total of 72 patients (29.6%) underwent a SUS ordered by their pediatrician prior to the pediatric urology visit. Pediatricians should be aware that SUS performed prior to pediatric urological evaluation does not alter management and is associated with a significant financial cost in patients with cryptorchidism or hydrocele.

Effectiveness of Laparoscopy in the Treatment of Pediatric Hydrocele: A Systematic Review

Objective: To conduct a systematic review of the published studies concerning laparoscopic pediatric hydrocele (PH) repair and summarize the surgical details and operative outcomes of this procedure. Materials and Methods: A PubMed search was performed for all studies concerning laparoscopic repair of hydrocele in children. The search strategy was as follows: (laparoscop* OR coelioscop* OR peritoneoscop* OR laparoendoscop* OR minilaparoscop*) AND hydrocele* AND (child* OR pediatric*). Inclusion criteria included (1) children with hydrocele as the study participant; (2) laparoscopic PH repair as the main surgical procedure; and (3) operation time and complications as the outcomes of interest. Reviews, studies with insufficient information or reporting the outcomes of abdominoscrotal hydrocele, and duplicate patient series were excluded. Results: Overall, 20 studies fulfilled the inclusion criteria of this review and 15 studies were included in the final analysis. These studies comprised at least 2920 patients undergoing laparoscopic repair for various PH subtypes, of which most were conducted in Asia. Most authors repaired PH laparoscopically through an extraperitoneal approach, while only a few studies applied a laparoscopic intraperitoneal method. The majority of the studies used nonabsorbable sutures to ligate hydrocele sac, while very few studies used absorbable materials. Hydrocele sac was resected or transected in only five studies, but left alone in the majority. Mean operation time was between 15.6 and 43.2 minutes for unilateral laparoscopic PH repair and between 16.9 and 53.2 minutes for bilateral surgery. Operative complications were not very common, with a highest recurrence/persistence incidence of 1.4%. Subgroup analysis showed that hydrocele subtype, surgical approach, suture material, and management of hydrocele sac did not significantly influence the operative complications. Conclusions: laparoscopic PH repair seems to be a safe and effective procedure. Given the limitations of this review, our conclusion needs to be confirmed by more well-designed studies.

Bilateral abdominoscrotal hydrocele in childhood

Introduction. Bilateral abdominoscrotal hydrocele is a rare entity in childhood. The etiology of abdominoscrotal hydrocele has not been fully clarified. The diagnosis is based on clinical examination, ultrasound and magnetic resonance imaging. The treatment is surgery. Case outline. This paper presents an eight-month-old boy who was admitted at the department of pediatric surgery due to bilateral swellings in the scrotum area. The changes were first noticed when he was three months old and the diagnosis of bilateral abdominoscrotal hydrocele was confirmed after the scrotum ultrasound examination. When the patient was six and eight months old, the symptoms have significantly increased, the magnetic resonance of the abdomen and the lesser pelvis was performed, and the bilateral abdominoscrotal hydrocele was successfully treated with inguinal surgery. The operative and postoperative course was uneventful. Conclusion. In this paper, we presented a rare form of hydrocele in children, as well as diagnostic evaluation that involved ultrasound and magnetic resonance examination. Surgical treatment by inguinal approach is also presented.

Does the laparoscopic treatment of paediatric hydroceles represent a better alternative to the traditional open repair technique? A retrospective study of 1332 surgeries performed at two centres in China

PurposeTo evaluate the safety, efficacy and merits of laparoscopic repair in children with hydroceles by comparing the outcomes of laparoscopic repair and the traditional open repair (OR) procedure. The outcomes of the following three laparoscopic percutaneous extra-peritoneal closure (LPEC) approaches were also compared: conventional two-port surgery, transumbilical single-site two-port surgery and single-port surgery.MethodsWe retrospectively compared the demographic, perioperative and follow-up data from the consecutive records obtained for 382 boys who underwent OR and 950 boys who underwent LPEC at two children’s medical centres in China. In the LPEC group, regardless of the hydrocele form, one of the three approaches with percutaneous aspiration was performed: conventional two-port surgery was performed in 387 cases, single-site two-port surgery was performed in 468 cases and single-port surgery was performed in 95 cases. The clinical data and complications were statistically analysed.ResultsPostoperative follow-up data were obtained for all the patients. The mean follow-up time was 36 months (24–48 months) in the OR group and 32.5 months (20–44 months) in the LPEC group. Significant differences in recurrence were not observed between the groups (five in the OR and 10 in the LPEC; P = 0.69). However, the operation time, postoperative hospital stay, incidence of scrotal oedema, incision infection and contralateral metachronous hernia or hydrocele were significantly higher in the OR group than those in the LPEC group (P < 0.01). Eighteen children (4.71%) had a negative exploration of the patent processus vaginalis (PPV) in the OR group. Fourteen children (1.47%) in the LPEC group had a closed internal ring and were converted to a scrotal procedure. Significant differences in the clinical data or complications were not observed between the two centres for the laparoscopic procedure (P > 0.05). Contralateral PPV (cPPV) was found in 18 patients in the single-port group (18.9%). Of the patients affected with cPPV, significant differences were observed between the single-port group and the two-port LPEC group (122 patients, 31.5%, P = 0.016) and the single-site two-port group (the 148 patients, 31.6%, P = 0.013). A contralateral metachronous hernia or hydrocele was found in zero, zero and two cases in these groups, respectively, and significant differences were observed (P < 0.01) between the single-site surgery and the other two laparoscopic approaches.ConclusionsLPEC is safe, feasible and effective for treating hydroceles in children and has the same recurrence rate as OR. However, LPEC is superior in operation time, hospital stay, occurrence of scrotal oedema, incision infection and occurrence of metachronous hernia or hydrocele. The transumbilical single-site two-port procedure has the same cosmetic effect as the single-port LPEC. According to our experience, the two-port LPEC approach is better for diagnosing cPPV and reducing metachronous hernia or hydrocele than the single-port LPEC procedure.

Learning Curves for Laparoscopic Repair of Inguinal Hernia and Communicating Hydrocele in Children.

We analyzed the department and surgeon learning curves during implementation of the percutaneous internal ring suturing (PIRS) technique in our department. Children proposed for inguinal hernia or communicating hydrocele repair were included (n = 607). After mentorship, all surgeons were free to propose open or PIRS repair. From gathered data, we assessed department and surgeon learning curves through cumulative experience focusing in perioperative complications, conversion, ipsilateral recurrence, postoperative complications, and metachronous hernia, with benchmarks defined by open repair. Department-centered analysis revealed that perioperative complications, conversion, and ipsilateral recurrence rates were higher in the beginning, reaching the benchmarks when each surgeon performed, at least, 35 laparoscopic repairs. Postoperative complications and metachronous hernia rates were independent from learning curves, with the metachronous hernia rate being significantly lower in PIRS patients. During the program, the percentage of males in those operated by PIRS progressively increased reaching the percentage of males, in our sample, when department operated over 230 cases. Thirty-five laparoscopic cases per surgeon are required for perioperative complications, conversion, and ipsilateral recurrence reach the benchmark. The gap between the percentage of males, in those operated by PIRS and in those proposed for surgery, monitors the confidence of the team in the program.

Efficacy of the traditional Japanese medicine goreisan for the resolution of spermatic cord hydrocele in children.

Goreisan, a traditional Japanese medicine, has previously been used for hydrostatic modulation. This retrospective study investigated the efficacy of goreisan for spermatic cord hydrocele resolution in children. Seventy-two boys treated for spermatic cord hydrocele between 2012 and 2015 were included; Goreisan was administered to 16 [group G, median age 3 (1-8)years], and 56 were followed without medication [group C, median age 1 (0-8)years]. An age-matched comparison was conducted between 14/16 group G patients (group g) and 14/56 group C patients (group c). Incidences of resolution were higher in groups G and g than in groups C and c, respectively, both during the study period and within the first 6-month observation period; groups G and g also had a significantly lower incidence of surgery for hydrocele than in groups C and c, respectively. The interval from the commencement of observation until hydrocele resolution was significantly shorter in group G than in group C, but not in group g than in group c. Goreisan can effectively promote the resolution of spermatic cord hydrocele in children and may be a valid treatment choice for this condition.

Percutaneous internal ring suturing is a safe and effective method for the minimal invasive treatment of pediatric inguinal hernia: Experience with 250 cases

Background/PurposePercutaneous internal ring suturing (PIRS) is a minimally invasive method for repair of pediatric inguinal hernia. In this study we report our experience with PIRS. MethodsAll children >10kg presenting to our institute between June 2013 and March 2015 with a diagnosis of indirect inguinal hernia or communicating hydrocele underwent laparoscopic repair using PIRS technique. Patients' gender, age at surgery, side of inguinal hernia/communicating hydrocele at diagnosis, peroperative findings, surgical and anesthesia times plus follow-up findings were collected. ResultsTwo-hundred thirteen patients underwent 250 procedures. Inguinal hernia or communicating hydrocele was diagnosed on the right side in 113 (53.1%), the left side in 75 (35.2%) and bilaterally in 25 patients (11.7%). Contralateral hernia was found in 35 patients (16.4%). Mean surgery time was 14.3min for unilateral and 20.4min for bilateral PIRS, and mean anesthesia time was 33.6min for unilateral and 39.1min for bilateral PIRS. Average follow-up time was 9.6months. Recurrence was seen in 3 (1.4%) and complications in 6 patients (2.8%). ConclusionPIRS is a simple, safe and effective method for the treatment of inguinal hernia and communicating hydrocele in children.

소아의 일측 음낭수종 교정술 후 반대측 발생의 치험 1례

Abstract A Case Study of Contralateral Occurrence after Unilateral Repair of Hydrocele inChildren Kim Eun Jin ․ Min Sang Yeon ․ Kim Jang Hyun Department of Pediatrics, College of Oriental Medicine, Dongguk University Objectives Hydrocele is a common disease found in pediatrics and is usually treated by hydrocelectomy, and even after the unilateral repair of hydrocele, it has been reported that the contralateral hydrocele still occurs in 5.4-12.5%. Therefore, the purpose of this study is to conduct a case study of contralateral hydrocele treated by Oryeong-san and Bangkeehwangkee-tang (五苓散 合 防己黃芪湯). Methods A patient diagnosed with San Syndrome (Su-San) (水疝) was administered Oryeong-san and Bangkeehwangkee- tang (五苓散 合 防己黃芪湯). Results The sizes of hydrocele and symptoms were reduced. Conclusions In the case of contralateral occurrence after unilateral repair of hydrocele in children, it is better to select a safer treatment than operation considering other possible complications. In this report, we have proven that Oryeong-san and Bangkeehwangkee-tang (五苓散 合 防己黃芪湯) can be very effective in reducing the size of hydrocele, improving symptoms and preventing recurrence.

Herniotomy in resource-scarce environment: Comparison of incisions and techniques.

Background:There are various methods for surgical treatment of hernia and hydrocele in children with variable cost-effectiveness, recovery and cosmetic outcomes. This study analyses our experience with mini-incision/invasive herniotomy in children in resource-limited centre.Materials and Methods:Seven hundred and eighty-four n = 784 patients underwent herniotomy via conventional and mini-invasive methods were assigned into Group A and Group B. Three hundred and seventy-six n = 376 (47.95%) in Group A while four hundred and eight n = 408 (52.04%) in Group B. Eight hundred and seventeen (817) herniotomy was performed. Demographic data, hernia/hydrocele sides, volume of surgical suture used, surgery duration, and complications analysed.Results:Right side hernia and/or hydrocele were 464 (59.18%). 287 (36.60%) had left sided while 33 (4.21%) had bilateral hernia and/or hydrocele. There were 14 bilateral hernia repair in Group A and 19 in Group B. The lengths of operation time for unilateral repair ranged from 14 to 54 min in Group A (median, 23 min) and 7-44 min in Group B (median, 15 min) with a mean surgical duration of 15.48 ± 4.16 min in Group B versus 23.41 ± 5.94 min in Group A (P < 0.001) while the range of the lengths of operation time for bilateral repair in Group A was 20-54 min (median, 36) and 12-30 min (median, 21) in Group B with a mean duration of 36.35 ± 9.89 min in Group A versus 20.42 ± 4.83 min in Group B P = 0.00563. 376 sachets of 45 cm suture material were used in Group A versus 137 in Group B. There were total of 87 (23.13%) complications in Group A versus 3 (1.47%) in Group B P = 0.000513. Superficial wound infection and abscess were 9 (2.36%) and 16 (4.25%) in Group A versus none (0) in Group B.Conclusion:Mini-incision/invasive herniotomy in children and adolescents is fast, cost-effective with satisfactory cosmetic outcome and limited complications

Observation on therapeutic efficacy of thunder-fire moxibustion for 10 cases of testicular hydrocele in infants

ObjectiveTo observe the clinical efficacy of thunder-fire moxibustion on pediatric testicular hydrocele. MethodsThunder-fire moxa was used for suspending moxibustion on Shu▪dào (▪ ST 28) and Guānyuán (▪ CV 4) on both sides for 10 children with testicular hydrocele, the moxa stick was kept 2–3 cm above from the skin and the moxibustion was carried out until the skin become red and hot for about 15–20 min. The treatments were carried out once a day and ten times were considered as a treatment course, and the therapeutic efficacy was subjected to statistics after two treatment courses. ResultsEight cases were cured, and effective in 2 cases; the cured rate was 80% and the effective rate was 100%. ConclusionThunder-fire moxibustion has relatively good clinical efficacy in treating testicular hydrocele in children.