Incidence and Management of Hydrocele Following Varicocele Surgery in Children
2004; Lippincott Williams & Wilkins; Volume: 171; Issue: 3 Linguagem: Inglês
10.1097/01.ju.0000112928.91319.fe
ISSN1527-3792
AutoresCiro Esposito, JEAN STEPHANE VALLA, Azad Najmaldin, F. L. Shier, Girolamo Mattioli, Antonio Savanelli, Marco Castagnetti, GORDON McKINLEY, HENRY STAYAERT, Alessandro Settimi, Vincenzo Jasonni, JEAN MICHAEL GUYS,
Tópico(s)Sexual Differentiation and Disorders
ResumoNo AccessJournal of UrologyPEDIATRIC UROLOGY1 Mar 2004Incidence and Management of Hydrocele Following Varicocele Surgery in Children CIRO ESPOSITO, JEAN STEPHANE VALLA, AZAD NAJMALDIN, FELIX SHIER, GIROLAMO MATTIOLI, ANTONIO SAVANELLI, MARCO CASTAGNETTI, GORDON McKINLEY, HENRY STAYAERT, ALESSANDRO SETTIMI, VINCENZO JASONNI, and JEAN MICHAEL GUYS CIRO ESPOSITOCIRO ESPOSITO , JEAN STEPHANE VALLAJEAN STEPHANE VALLA , AZAD NAJMALDINAZAD NAJMALDIN , FELIX SHIERFELIX SHIER , GIROLAMO MATTIOLIGIROLAMO MATTIOLI , ANTONIO SAVANELLIANTONIO SAVANELLI , MARCO CASTAGNETTIMARCO CASTAGNETTI , GORDON McKINLEYGORDON McKINLEY , HENRY STAYAERTHENRY STAYAERT , ALESSANDRO SETTIMIALESSANDRO SETTIMI , VINCENZO JASONNIVINCENZO JASONNI , and JEAN MICHAEL GUYSJEAN MICHAEL GUYS View All Author Informationhttps://doi.org/10.1097/01.ju.0000112928.91319.feAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Hydrocele seems to be the most frequent complication in children who undergo surgery for varicocele and the issue of the optimal management of hydrocele remains controversial. In this retrospective study we evaluated the incidence and management of hydrocele following surgical treatment of varicocele in children treated at 8 European centers of pediatric surgery. Materials and Methods: In a 5-year period 278 children between 7 and 17 years old underwent surgical treatment for unilateral left varicocele, including 187 using video surgery and 91 via an open inguinal approach. Results: At an average followup of 24 months (range 12 to 60) 34 children (12.2%) had a left hydrocele. Of the 278 children 14 (5%) were lost to followup. The hydrocele appeared between 1 week and 44 months (median 2 months) after surgery. Concerning hydrocele management 16 of 34 children (47%) were treated with scrotal puncture while under local anesthesia, which led to hydrocele regression after a median of 3 punctures (range 1 to 5), 12 (35.3%) underwent clinical observation since the hydrocele reduced spontaneously within a median of 12 months after its appearance and 6 (17.7%) were treated with open surgery. In 4 cases the hydrocele disappeared and in 2 it recurred after surgery and was successfully treated with punctures. Conclusions: This study shows that the median incidence of hydrocele after varicocele surgery is about 12% but it seems higher after artery nonsparing vs sparing procedures (17.6% vs 4.3%). On the contrary, no difference was found when the procedure was performed using video surgery or with the open approach. Hydroceles generally develop a few months later but may also appear several years after the surgical repair of varicocele. Noninvasive procedures (scrotal punctures or clinical observation) seem to induce total hydrocele regression in more than 82% of cases. Children who undergo surgery for varicocele should undergo long-term followup to detect a possible hydrocele. In fact, the 5.4% of children lost to followup in our study may potentially have had a hydrocele. Surgery is not always successful for this condition, as shown in the 2 cases of recurrent hydrocele after surgical repair. References 1 : Laparoscopy in the management of pediatric varicoceles. J Pediatr Surg1997; 32: 1470. Google Scholar 2 : Laparoscopic surgery for pediatric varicoceles: randomized controlled trial. J Pediatr Surg2002; 37: 727. Google Scholar 3 : Laparoscopic treatment of pediatric varicocele: a multicenter study of the Italian society of video surgery in infancy. J Urol2000; 163: 1944. Link, Google Scholar 4 : The adolescent varicocele. 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Google Scholar From the Pediatric Surgery Units, Magna Graecia University (CE), Catanzaro, University of Genova (GM, VJ), Genoa and "Federico II" University of Naples (AS, AS), Naples, Italy, Fondation Lanval (JSV, HS), Nice and La Timone Hospital (MC, JMG), Marseille, France, National Institutes of Health, Leeds (AN) and Edinburgh (GM), United Kingdom, and University of Jena (FS), Jena, Germany© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySchwentner C, Oswald J, Lunacek A, Deibl M, Bartsch G and Radmayr C (2018) Optimizing the Outcome of Microsurgical Subinguinal Varicocelectomy Using Isosulfan Blue: A Prospective Randomized TrialJournal of Urology, VOL. 175, NO. 3, (1049-1052), Online publication date: 1-Mar-2006.Hassan J, Adams M, Pope J, Demarco R and Brock J (2018) Hydrocele Formation Following Laparoscopic VaricocelectomyJournal of Urology, VOL. 175, NO. 3, (1076-1079), Online publication date: 1-Mar-2006. Volume 171Issue 3March 2004Page: 1271-1273 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordspostoperative complicationsvaricocelehydroceletestisMetricsAuthor Information CIRO ESPOSITO More articles by this author JEAN STEPHANE VALLA More articles by this author AZAD NAJMALDIN More articles by this author FELIX SHIER More articles by this author GIROLAMO MATTIOLI More articles by this author ANTONIO SAVANELLI More articles by this author MARCO CASTAGNETTI More articles by this author GORDON McKINLEY More articles by this author HENRY STAYAERT More articles by this author ALESSANDRO SETTIMI More articles by this author VINCENZO JASONNI More articles by this author JEAN MICHAEL GUYS More articles by this author Expand All Advertisement PDF downloadLoading ...
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