What are the hydrocele treatment controversies?

Updated: Oct 28, 2020
  • Author: Jacob C Parke, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Many surgeons have begun to advocate routine diagnostic laparoscopy of the contralateral groin in patients (particularly children) with unilateral hernias. The premise is that unsuspected contralateral hernias are repaired prior to clinical recognition. However, many more patent processus are being ligated than true hernias are being repaired. Whether an increased use of this technique will reduce the incidence of hydroceles in older children or adults remains to be seen. Furthermore, whether utilization of this intraoperative modality is of any utility in inguinal hydrocele repairs is open for debate.

Medical management, or, more importantly, prevention of patent processus vaginalis, has been theorized as possible after full elucidation of the intricate molecular processes that control fetal cell migration, proliferation, and adherence. Although the idea of preventing hydroceles or indirect hernias is interesting, it is far from being applicable in clinical medicine.


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