Scrotal approach for the correction of an abdominoscrotal hydrocele: Medium term follow-up (original) (raw)
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Urology, 2010
To introduce a modified trans-scrotal approach for treatment of abdominoscrotal hydrocele (ASH) in children. The postoperative outcomes are reviewed with long-term follow-up.We described a series of 7 boys (mean age, 23.4 months) who underwent surgical repair of ASH. The diagnosis was made based on physical examination, which revealed a tense hydrocele in association with ipsilateral cystic abdominal mass, confirmed by ultrasonography. After exposing the hydrocele sac through a scrotal incision, tunica vaginalis was opened and marsupialization of the hydrocele along with undermined dartos muscle layer was performed. Follow-up ranged from 9-12 months (average, 10.7 months).Overall, 10 ASH units (including 3 bilateral) were repaired. All of the affected testicles except one showed some degree of dysmorphism, according to ultrasonography or intraoperative findings, which resolved in all patients 3 months after surgery. There were no early postoperative complications except a mild scrotal edema. Neither recurrences of ASH nor testicular atrophy was observed.The diagnosis of ASH should be considered in a boy with hydrocele and concomitant abdominal mass, and can be established by ultrasonographic evaluation. Our experiment suggests that the modified trans-scrotal surgical method for management of ASH is reliable and effective with definite advantages. The high success rate, no extensive dissection of the inguinal canal, or complete excision of the sac, along with safety and simplicity of the procedure and short hospital stay, are important preconditions for the introduction of this method as a valid option for treatment of ASH.
Both-sided Large Abdominoscrotal Hydrocele Associated with Testicles Atrophy
Medical Archives, 2011
A bdominoscrtoal hydrocele is unusual condition with large scrotal hydrocele, which communicates through narrow inguinal channel with abdominal component. Abdominoscrotal hydrocele is not a benign condition, because complications such as acute appendicitis, testicular dismorphism, ureterohydronephrosis, paratesticular malignity have been described earlier. This case study describes one year old boy with both-sided abdominoscrotal hydrocele. Abdominal masses connected with hydrocele need to induce a suspicion of this condition. Early diagnosis and existing surgical techniques for treatment of this disorder are the key factors in prevention of complications associated to this disorder.
Large abdominoscrotal Hydrocele: Uncommon surgical entity
International Journal of Surgery Case Reports, 2015
INTRODUCTION: An abdominoscrotal hydrocele (ASH) consists of a large inguinoscrotal hydrocele which communicates in an hour glass fashion with a large "intraabdominal component". Mostly affects single testis but very rarely can present bilaterally. PRESENTATION OF CASE: We are presenting here a young 25 year old patient with large right sided scrotal swelling encroaching over lower abdomen. Clinically it was abdominoscrotal hydrocele which was confirmed with CT abdomen and later on subjected for surgery. DISCUSSION: Abdominoscrotal hydrocele is rarest type of hydrocele; first described by Dupuytren. The etiology of ASH is unknown; however, different theories have been described in literature to explain the pathogenesis. Diagnosis of ASH is done by clinical examination and is confirmed by radiological examination. Though ultrasonography is the first choice, in few selected cases contrast enhanced computerized tomography or magnetic resonant imaging may be helpful for more anatomical delineation. It may present with various complications secondary to pressure exerted by the components of the ASH. Surgical excision of the sac is the only definitive treatment option. There is no role of conservative treatment. Sometimes, decompression of the cyst needed to ease the dissection of the sac. CONCLUSION: Abdominoscrotal hydrocele differential should be considered while dealing with large lower abdominal swelling along with scrotal swelling.
Bilateral abdominoscrotal hydrocele in childhood
Srpski arhiv za celokupno lekarstvo
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 ...
Giant unilateral abdominoscrotal hydrocele in association with crossed testicular ectopia
Urology, 2006
Abdominoscrotal hydrocele and transverse testis ectopia are rare clinical conditions. This case report describes the combination of these two rare entities. An azoospermic and infertile adult man presented with left abdominoscrotal hydrocele and a right impalpable testis. He was treated with left orchiopexy, right orchiectomy, and excision of the abdominoscrotal hydrocele. We discuss the diagnosis and treatment of this combination, which has not been previously reported.
Abdominoscrotal hydrocele in childhood: is it really a rare entity?
Urology, 2000
Objectives. Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood, with only about 80 pediatric cases reported in the modern literature. Methods. The incidence, diagnosis, and treatment of ASH are discussed with reference to 9 cases observed at our institution and to cases in the literature. Results. Surgical correction was successful in all our cases and no hydrocele or hernia recurrence was registered. Conclusions. ASH incidence appears to be higher than reported; undescended testis is a frequent association and surgical correction through an inguinal approach is always possible and curative. Ligation of the processus vaginalis may prevent recurrence.
Abdomino-Inguino-Scrotal Hydrocele (Ten-Hydroceles with Intraabdominal Extension)
Journal of King Abdulaziz University-Medical Sciences, 2003
Hydrocele with intraabdominal extension is a rare condition in children. We managed 10 hydrocele in 7 infants (3 bilateral and 4 unilateral). Eight hydrocele were abdominoscrotal and two were abdominoinguinal which represents intraabdominal extension of encysted hydrocele. Obstetric history of 6 mothers of this present study's patients supported the authors' previously proposed explanation of the push-up of the hydrocele intraabdominally by external pressure on the scrotoinguinal compartment, this pressure is created by strong uterine contractions or intra-uterine fetal position. In this paper, we present our experience in management of this condition including some of its important clinical and morphological features. Additionally, we propose to call this condition as "Hydrocele with intraabdominal extension" which includes abdominoscrotal and abdominoinguinal in males and the abdominoinguinal (pushed up hydrocele of canal of Nuck) in females.
NON-INTERCOMMUNICATING ABDOMINOSCROTAL HYDROCELE WITH MULTI-SYSTEM ANOMALIES: A CASE REPORT
International Journal of Current Research and Review, 2017
Aim: Presentation of an abdominoscrotal hydrocele case with a very rare association to multiple anomalies and separate abdominal and inguinoscrotal sacs. Case Report: A 21-year-old male patient presented with left-sided abdominoscrotal hydrocele, impalpable right testis, hydro-cephalus and cerebral and musculoskeletal deformities. On abdominal ultrasonography, the abdominal and inguinoscrotal components were seen separated by a septum that was confirmed on surgery. Extended inguinal incision was used for repair and the post-operative course was uneventful. Discussion: Abdominoscrotal hydrocele is a rare entity and its simultaneous association to multiple anomalies, like in the current case, is a rarer finding. Non-intercommunication state is another very rare criteria of abdominoscrotal hydrocele which was clinically, sonographically and surgically demonstrated in this case. Extended inguinal incision was indicated and enough to deal with both abdominal and scrotal components. Conclusion: Abdominoscrotal hydrocele is mostly intercommunicating, but it is exceptionally non-intercommunicating and associated to multiple anomalies. Surgical excision via an extended inguinal incision may be indicated for voluminous cases and those with a solitary testis.
A Mini Review on Hydrocele: The Most Common Scrotal Problem
Abnormal collection of serous fluid between the visceral and parietal layers of the tunica vaginalis is termed as hydrocele. It is the commonest reason for painless scrotal swelling and affects about 1% of men, mostly above forty years of age, and 4.7% neonates. Normally it is idiopathic in origin, yet infection, variococelectomy, inguinal surgery, a patent processus vaginalis and trauma are linked with its consequent expansion. Surgical removal of hydrocele is still considered as the gold standard of care. Cases have been reported with high success rates, 85%-96%, after using aspiration and sclerotherapy in combination. This article reviews some aspect of treatment and complication of Hydrocele.
The Egyptian Journal of Hospital Medicine, 2021
Background: The inguinal method is utilized for treating hydrocele in the pediatric populace. While, investigations on scrotal orchiopexy have declared herniation or hydrocele repairing via the same scrotal cut as a portion of an orchiopexy operation, there are a few researches investigating the treatments of separated communication hydrocele via a scrotal incision. Objective: To compare between scrotal and inguinal surgery for repair of communicating hydrocele in kids with assessment of surgical period, intraoperative complications, hospitalization, and postoperative complication.