Christensen Tyler, Cartwright Patrick C, Devries Catherine, Snow Brent W
University of Utah, Salt Lake City, Utah 84113, USA.
Int J Urol. 2006 Nov;13(11):1425-7. doi: 10.1111/j.1442-2042.2006.01583.x.
The presentation, and medical and surgical management of all new onset non-congenital hydroceles in boys older than 1 year of age were examined. Of particular interest was the outcome of those patients who presented with a non-communicating hydrocele that developed after the first year of life and was managed conservatively.
All patients older than 12 months of age who were evaluated as outpatients with the diagnosis of hydrocele from January 1994 to January 2001 were identified. Possible risk factors and predisposing conditions were determined. For the patients who had surgical correction, surgical indications were identified. For non-surgical patients, long-term outcomes were recorded.
A total of 302 patients older than 12 months of age with the diagnosis of new onset hydrocele were identified. Of these, 35% were non-communicating, 59% were communicating, and 6% were hydroceles of the spermatic cord. In terms of surgery, 97% of communicating hydroceles, 71% of hydroceles of the spermatic cord, and 34% of non-communicating hydroceles had operative management. Seventy patients with non-communicating hydroceles did not receive surgery and 51 (73%) were contacted for long term follow-up. In these 51 patients, 76% of non-communicating hydroceles resolved completely, 6% decreased in size but were still present, 14% remained the same size, and 4% had an unknown status. The average time to resolution was 5.6 months with a median time of 3 months. The time range to resolution was from 1 day to 24 months. Follow-up averaged 73.7 months with a range of 33 to 120 months.
Approximately 75% of new onset, non-congenital, non-communicating hydroceles resolve spontaneously irrespective of size. An observation period of 6-12 months would be appropriate prior to repair.
对1岁以上男孩所有新发性非先天性鞘膜积液的表现、内科及外科治疗进行研究。特别关注那些在1岁后出现的非交通性鞘膜积液且接受保守治疗的患者的治疗结果。
确定1994年1月至2001年1月期间门诊诊断为鞘膜积液的所有12个月以上患者。确定可能的危险因素和诱发因素。对于接受手术矫正的患者，确定手术指征。对于非手术患者，记录长期治疗结果。
共确定302例12个月以上新发性鞘膜积液患者。其中，35%为非交通性，59%为交通性，6%为精索鞘膜积液。在手术方面，97%的交通性鞘膜积液、71%的精索鞘膜积液和34%的非交通性鞘膜积液接受了手术治疗。70例非交通性鞘膜积液患者未接受手术，其中51例（73%）接受了长期随访。在这51例患者中，76%的非交通性鞘膜积液完全消退，6%体积减小但仍存在，14%大小不变，4%情况不明。平均消退时间为5.6个月，中位时间为3个月。消退时间范围为1天至24个月。随访平均73.7个月，范围为33至120个月。
约75%新发性、非先天性、非交通性鞘膜积液可自发消退，与大小无关。在修复前观察6 - 12个月是合适的。
