1. http://www.healthcommunities.com/hydrocele/symptoms-treatments.shtml
Complications of hydrocelectomy include blood clots, infection, and injury to the scrotal area. While hydroceles are not known to cause infertility, this can rarely result from surgery.
In most cases, surgery to correct a hydrocele in infant boys is not performed until the child is 12–18 months of age
2. http://www.patient.co.uk/health/hydrocele-in-children
Hydroceles usually improve without any treatment within the first year of life. An operation is usually only advised if the hydrocele persists after 12-18 months of age.
If your child also has a hernia, then this will usually be corrected in the same operation.
I have read 6 month and one year. I am not a surgeon and usually refer to pediatric surgeon for their decision.
Interesting that most answers go for an operation somewhere between 12 and 24 months of age. Is there any feeling out there that there may be further resolution of communicating hydroceles after the first two years of life? I don't operate till 4-5 yrs of age for this reason. It is after all a "cosmetic" procedure, so why the rush. Any opinion on that approach?
No, we have not. However we cannot stop the general practitioners from getting ultrasounds prior to referral.
Hydrocele in children is of 2 types. Congenital or communicating and infantile or non-communicating. Surgery is indicated for the congenital variety once diagnosed irrespective of the age. Conserve for one year for the infantile one naturally it will disappear. But if persist beyond that age surgery should be considered and deal with as it's congenital.
Agree with Dr. Ahmed's answer. What is best way to differentiate the two forms of hydrocoele in a community clinic with no special equipment? Is there a reliable way?
In my opinion, repair depends on your goals. Hydroceles come in many varieties. The risks of not repairing must be balanced with the risks of the operation - and anesthesia, etc. The biggest risk associated with hydroceles is inguinal hernia and incarceration. This occurs, in my opinion, when the patent processus vaginalis opens enough to become a tight hernia. Before then, it is a communicating hydrocele. Not all progress, and some may resorb. The other risks of testicular torsion, etc. are real, and should be considered. Also, complicated hydroceles, like bottle type, etc, need to be considered. I use ultrasound to assess, and also assess the testicle in males as it is often not palpable. The balance of timing and repair depends on the system, safety, and the skills of the surgeon, and the discussion with the family. For some cases of non-communicating hydrocele, aspiration may be curative.
Best time is after 3 years of age, once the peritoneal-vaginal duct is not close. There are any indications to correct the defect before this age.
I don't agree with aspiration being a choice in this topic. There are risks involved, such as in surgery,but the probability of recurrence is much higher. There are some sparse reports of cure after aspiration, but we cannot rely on the small minority of those cases. In my opinion the timing is highly dependent on the type of hydrocele, volume and family's opinion, being aware that the younger the patient the higher risks from surgery and anaesthesia. In an uncomplicated hidrocele of small to moderate volume, with no testicular complications, I agree with the limit of 3 years of age.
4-5 years unless abdominoscrotal hydrocele.
It is a cosmetic operation unless hydrocele is secondary to omentum blocking a hernia sac.
I believe that the question is the type of hydrocele not when. if the hydrocele is so tense we advised parents to perform operation irrespective to the age. if there is communication with the peritoneal sac we also advised parents to perform the procedure.
I agree with Dr.Ahmed, but how can we clinically differentiate between the two?
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