Yamaguchi T, Nagata T, Hamasuna R, Osada Y
Department of Urology, Miyazaki Medical College.
Nihon Hinyokika Gakkai Zasshi. 1996 Nov;87(11):1243-9. doi: 10.5980/jpnjurol1989.87.1243.
The purpose of this study is to confirm the definite indication for surgery of pediatric testicular and funicular hydroceles in view of natural course.
During the period from 1978 to 1994, we encountered 160 hydroceles in 149 pediatric patients. Patients ages ranged from 5 days after birth to 13 years and the mean follow-up periods was 4.7 years. We investigated the indication for surgery of pediatric hydroceles in six points of view: value of an aspiration of hydroceles, of what testicular or funicular or both, communication, size, age and testicular development.
Nevertheless, of 160 hydroceles, 66 (41%) were performed an aspiration of hydroceles, the aspiration of hydrocele was ineffective in the majority of patients. Common hydroceles in neonates and infants required no specific treatment, as the majority of hydrocele resolve spontaneously, however surgical treatment was required for a communicating large hydrocele that had been often attacked by aspiration and appeared at older age. Funicular hydroceles were more difficult to spontaneous healing. Ipsilateral testis manifests a well-developed comparing control material.
The indication for surgery of pediatric hydroceles were as follows: 1) hydroceles complicated by a inguinal hernia or cryptorchidism, 2) hydroceles appeared at older age and not resolved during 2-3 years over, 3) giant communicating funicular and testicular hydroceles present with an/hindrance for daily life.
本研究旨在从自然病程的角度确定小儿睾丸鞘膜积液和精索鞘膜积液的明确手术指征。
1978年至1994年期间，我们诊治了149例小儿患者的160例鞘膜积液。患者年龄从出生后5天至13岁，平均随访时间为4.7年。我们从鞘膜积液抽吸的价值、睾丸或精索或两者的情况、交通情况、大小、年龄和睾丸发育六个角度研究了小儿鞘膜积液的手术指征。
然而，在160例鞘膜积液中，66例（41%）进行了鞘膜积液抽吸，大多数患者鞘膜积液抽吸无效。新生儿和婴儿的普通鞘膜积液无需特殊治疗，因为大多数鞘膜积液可自行消退，然而，对于经常因抽吸而发作且在较大年龄出现的交通性大鞘膜积液则需要手术治疗。精索鞘膜积液更难自行愈合。患侧睾丸与对照材料相比发育良好。
小儿鞘膜积液的手术指征如下：1）合并腹股沟疝或隐睾的鞘膜积液；2）在2至3年以上仍未消退且出现在较大年龄的鞘膜积液；3）巨大交通性精索和睾丸鞘膜积液对日常生活造成影响。
