Document Detail


Pressure, fluid and anatomical characteristics of abdominoscrotal hydroceles in infants.
MedLine Citation:
PMID:  18708213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Abdominoscrotal hydrocele is a poorly understood entity and multiple theories attempt to explain its occurrence. To our knowledge the factors contributing to the formation of abdominoscrotal hydrocele are unknown, as are its cellular, biochemical and hydrostatic properties. We prospectively evaluated abdominoscrotal hydrocele at surgery to define its cause and its effects on the testicle. MATERIALS AND METHODS: Six patients (9 abdominoscrotal hydroceles) were prospectively evaluated at surgery. Hydrocele volume was recorded as well as simultaneous hydrocele and bladder pressure. Fluid at surgery was sent for biochemical and cellular analysis. Testicular and epididymal abnormalities were noted and testicular length was measured. All abdominoscrotal hydroceles were exteriorized and excised. Processus vaginalis patency was documented at repair. RESULTS: Mean patient age was 7.17 months (range 5 to 12). The mean volume recorded was 212.78 ml (range 80 to 320). Mean corrected hydrocele pressure was 15.44 cm H(2)O (range 7 to 28). Mean testicular length was 3.6 cm (range 2.2 to 5.5). All patients had epididymal anomalies and 2 of the 3 unilateral abdominoscrotal hydroceles had abnormal contralateral scrotal findings. In no case was a peritoneal communication identified. Fluid analysis revealed a high protein concentration (mean 4.94 gm/dl), low triglyceride concentration (mean 20.29 mg/dl) and lactate dehydrogenase levels comparable to those in normal serum (mean 99.14 U/l). Cytological analysis revealed a sterile, low cellularity fluid with a macrophage predominance (mean 84.71%). CONCLUSIONS: Abdominoscrotal hydrocele occurs as a result of increased intraluminal pressure confined in a proximal closed processus vaginalis. Increased hydrocele pressure allows expansion into the retroperitoneal space through the internal inguinal ring. This increased pressure is associated with testicular elongation and epididymal abnormalities. The exudative fluid is of a noninfectious etiology and it suggests an altered filtration process. To our knowledge the effects on future fertility are unknown.
Authors:
Aaron Bayne; Darius Paduch; Steven J Skoog
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Publication Detail:
Type:  Journal Article     Date:  2008-08-16
Journal Detail:
Title:  The Journal of urology     Volume:  180     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-12     Completed Date:  2008-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1720-3; discussion 1723     Citation Subset:  AIM; IM    
Affiliation:
Division of Urology and Renal Transplantation, Oregon Health and Science University, Portland, Oregon, USA.
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MeSH Terms
Descriptor/Qualifier:
Epididymis / pathology
Humans
Hydrostatic Pressure
Infant
L-Lactate Dehydrogenase / blood
Magnetic Resonance Imaging
Male
Testicular Hydrocele / pathology,  physiopathology,  surgery*
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Triglycerides; EC 1.1.1.27/L-Lactate Dehydrogenase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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