RISK OF CONTRALATERAL HYDROCELE OR HERNIA AFTER UNILATERAL HYDROCELE REPAIR IN CHILDREN

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Abstract
Recent laparoscopic studies indicate a high incidence of a contralateral open internal ring in children undergoing unilateral hydrocele or hernia repair, raising the question of whether routine contralateral exploration should be done. Data on the long-term risk of clinical contralateral hernia or hydrocele after unilateral hydrocele repair are limited. To address this question we performed long-term followup in patients who underwent unilateral hydrocele repair. We followed patients who previously underwent unilateral hydrocele repair performed by one of us before 1997. Patients were interviewed by telephone and encouraged to return to one of us or their pediatrician for evaluation. Of the 101 patients who fulfilled study inclusion criteria 85 who were 5 to 107 months old (median age 37) at the original surgery were successfully contacted, including 45 examined by one of us or a pediatrician and 40 followed by telephone interview only. Contralateral hydrocele or hernia developed in 6 of the 89 patients (7%) 6 to 15 months (median 12) postoperatively. The remaining 79 patients have been recurrence-free for 6 to 153 months (mean 44, median 37). Of the patients 5 of 32 are (15%) and 1 of 53 (2%) who underwent left and right hydrocele repair, respectively, had contralateral recurrence. The risk of a clinically evident contralateral hydrocele or hernia after unilateral hydrocele repair is approximately 7%. We do not recommend routine contralateral exploration in children undergoing unilateral hydrocele repair.