In my experience, the pre-operative inguino-scrotal ultrasound usually add more information for surgen before groin hernias in children. If the patient with hernia has scrotum and other organs or tissues involved, the surgen will take surfficent pre-operation evaluation and take corresponding management in the operation, which will certainly affect the surgical outcome of groin hernias. On the other hand, if the hernia does not enter the scrotum and does not have other concurrent lesion, the pre-operative inguino-scrotal ultrasound evaluation will not add more information, thus it does not affect the surgical outcome of groin hernias in children.

Preoperative inguino-scrotal ultrasound no affect the surgical outcome of groin hernias in children 

Preoperative ultrasound has no role in inguinal hernia. The only possible place it may be useful is if there is doubt between a varicocele and a small hernia in an infant. A good history and examination is usually sufficient.

preoperative scrotal U/S in children doesn't add much and doesn't affect the outcome of the surgery

Pre-operative inguino-scrotal USG  in routine practice is neither advisable, nor going to affect the surgical outcome of groin hernias in children. USG may be helpful and needed in selected cases, when the clinical diagnosis is in doubt? 

What I do prior to operation when the clinical diagnosis of pediatric inguinal hernia / hydrocele is in doubt?

Now a days, many of the parents even in remote areas are with mobile phones with camera.  If any doubt arises on clinical diagnosis of hernia / hydrocele, ask them to click when the swelling appeared the maximum and provide to you for review of the particular case. This help in pre-op confirmation of the diagnosis and the side of the disease as well.

Yes sounds good we have to use the contemporary technology

Yours faithfully

Ultrasound to detect contralateral PPV is not useful. Laparoscopic herniotomy if performed will be able to assess the contralateral side accurately. I do laparoscopic herniotomy routinely. For those not doing lap herniotomy, clinical sign of thickened cord is adequate to predict PPV.

I think it is clinical diagnosis and there is no place for ultrasound and silent PPV do not need intervention

I also feel that  u/s is an unhelpful investigation. A patent processus on its own does not warrant surgery. I only operate on the side of the hernia. Unfortunately many of our patients present to us with an u/s which had been requested by their GP.