Acer-Demir Tuğba, Ekenci Berk Yasin, Özer Doğancan, Turanoğlu Mehmet Ali, Haberal Kadem Cem, Bilgin Elif Bengisu, Hiçsönmez Akgün
Department of Pediatric Surgery, Faculty of Medicine, Başkent University, Ankara, Turkey.
Faculty of Medicine, Başkent University, Ankara, Turkey.
Urology. 2018 Feb;112:155-160. doi: 10.1016/j.urology.2017.10.003. Epub 2017 Oct 13.
To elucidate epidemiological data and hydrocele progression, we reviewed pediatric patients diagnosed with hydroceles in our institution retrospectively.
We reviewed data from 355 pediatric patients with hydroceles. Questionnaires regarding age at diagnosis, time of delivery, presence of hydroceles in the father and brothers, age at recovery, age at surgery, cause of hydrocele (if present), type of hydrocele, associated pathologies, treatments, and posthydrocelectomy complications were completed by reviewing patients' medical records and interviewing their families.
Patients with congenital hydroceles were more frequently born prematurely (32.5%) than were patients with noncongenital hydroceles (15.9%; P = .001). Fathers of 10 patients (3.7%) and brothers of 21 patients (7.7%) also had hydroceles. Hydroceles were associated with inguinal hernias on the same side (12.2%), cryptorchidism (7.5%), varicoceles (6.0%), and testis torsion (0.5%). Among patients aged >1 year (n = 185), 27 did not undergo operations and healed spontaneously at an average of 5.30 ± 3.36 months. For children aged >1 year who did not undergo surgery, the rate of spontaneous recovery within 6 months was 77.8% and that within 1 year was 96.3%.
Until strong evidence of hydrocele-induced testicular damage in children arises, we recommend following up congenital hydroceles until at least 1 year and preferably 2 years of age. We recommend following up noncongenital hydroceles for at least 6 months and preferably 1 year if there is no associated pathology indicating the need for earlier surgery such as an inguinal hernia, cryptorchidism, tense hydrocele, testis torsion, or testis mass.
为阐明流行病学数据及鞘膜积液的进展情况，我们对在本机构诊断为鞘膜积液的儿科患者进行了回顾性研究。
我们回顾了355例儿科鞘膜积液患者的数据。通过查阅患者病历并与其家属访谈，完成了关于诊断年龄、分娩时间、父亲及兄弟是否存在鞘膜积液、恢复年龄、手术年龄、鞘膜积液病因（若有）、鞘膜积液类型、相关病理情况、治疗方法以及鞘膜切除术后并发症等方面的问卷调查。
先天性鞘膜积液患者早产的频率（32.5%）高于非先天性鞘膜积液患者（15.9%；P = 0.001）。10例患者（3.7%）的父亲及21例患者（7.7%）的兄弟也患有鞘膜积液。鞘膜积液与同侧腹股沟疝（12.2%）、隐睾（7.5%）、精索静脉曲张（6.0%）及睾丸扭转（0.5%）相关。在年龄大于1岁的患者（n = 185）中，27例未接受手术，平均在5.30 ± 3.36个月时自行愈合。对于年龄大于1岁未接受手术的儿童，6个月内自发恢复率为77.8%，1年内为96.3%。
在出现儿童鞘膜积液导致睾丸损伤的确凿证据之前，我们建议对先天性鞘膜积液至少随访至1岁，最好至2岁。对于非先天性鞘膜积液，如果没有诸如腹股沟疝、隐睾、张力性鞘膜积液、睾丸扭转或睾丸肿物等表明需要早期手术的相关病理情况，则建议至少随访6个月，最好随访1年。
