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Risk factors for contralateral patent processus vaginalis determined by transinguinal laparoscopic examination
Dong-Gi Lee1, Young-Suk Lee2, Kwan Hyun Park3
1Department of Urology, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Insights
Concurrent contralateral inguinal exploration in children with unilateral conditions is debated. This study found suspicious ultrasound findings and prior contralateral disease significantly increase the risk of contralateral patent processus vaginalis (CPPV).
Area of Science:
- Pediatric Surgery
- Urology
- Diagnostic Imaging
Background:
- The necessity of contralateral inguinal exploration in pediatric unilateral inguinal conditions remains controversial.
- Identifying contralateral patent processus vaginalis (CPPV) is crucial for preventing recurrence and complications.
Purpose of the Study:
- To determine the incidence of CPPV in children with unilateral inguinal conditions using inguinoscopy.
- To identify risk factors associated with CPPV to guide contralateral examination decisions.
Main Methods:
- Prospective study of 119 children undergoing ipsilateral surgery for unilateral hydrocele, inguinal hernia, or cryptorchidism between 2001-2008.
- Transinguinal laparoscopy (inguinoscopy) was performed during ipsilateral surgery to assess the contralateral inguinal region.
- Statistical analysis was used to evaluate the incidence of CPPV and associated risk factors.
Main Results:
- CPPV was confirmed in 29 out of 119 patients (24.4%) via inguinoscopy.
- Suspicious ultrasound findings (OR=13.800, P=0.004) and a history of contralateral disease (OR=4.008, P=0.019) were significant risk factors for CPPV.
- No surgical complications were reported during the inguinoscopy procedures.
Conclusions:
- Inguinoscopy is a safe and effective method for diagnosing CPPV.
- Children with suspicious ultrasound findings or a history of contralateral disease are at higher risk for CPPV, warranting contralateral assessment.
Abstract:
Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of debate. The aim of the present study was to investigate the incidence of contralateral patent processus vaginalis (CPPV) using transinguinal laparoscopy (inguinoscopy). In addition, the risk factors of CPPV were evaluated in order to facilitate the selection of appropriate candidates for contralateral examination. A total of 119 patients who presented with unilateral hydrocele, inguinal hernia or cryptorchidism between 2001 and 2008 underwent inguinoscopy during the ipsilateral surgery. All data were collected prospectively. The incidence of CPPV was investigated and the risk factors affecting the presence of CPPV were analyzed. Among these patients, 29 individuals (24.4%) had CPPV confirmed by inguinoscopy. No surgical complications were observed during the inguinoscopy. Cases with suspicious ultrasound findings were at a higher risk of CPPV than cases with normal findings (odds ratio, 13.800; P=0.004). A history of contralateral disease was also found to be a significant risk factor (odds ratio, 4.008; P=0.019). The present study identified that the significant risk factors for CPPV were suspicious findings on ultrasound examination and a history of contralateral disease. Therefore, it is concluded that performing inguinoscopy in children with these risk factors is beneficial.
