The role of transforming growth factor beta 1 in communicating and non-communicating hydrocele

Repair of inguinal hernia and hydrocele are one of the most common operations performed by surgeons. However, the exact biological mechanism responsible for the closure of processus vaginalis (PV) is not completely understood. Transforming growth factor beta 1 (TGF-β1) is a potent fibrogenic agent and probably stimulate fibrosis and disappearing of PV.

From September 2012 to December 2014, all boys from 1 to 5 years who were referred for surgery of hydrocele were divided into two groups of communicating (HC) or non-communicating hydrocele (HNC). During surgery, the fluid in the sac was aspirated and sent for biochemical evaluation including calcium, phosphorus, total protein, and TGF-β1. Finally, a biopsy of the sac was sent to the pathology. The results obtained were considered statistically significant (P < 0.05).

The patients were categorized into two groups of non-communicating hydrocele, including 43 patients and communicating, including 33. The patients studied were aged 1-5 years (mean 33.6 months). Biochemical tests on hydrocele fluid showed no significant difference in the levels of calcium, phosphorus, total protein, and bilirubin between two groups. However, mean TGF-β1 in NHC was found to be 53.45-114.28 pg/ml in HC group. A statistically significant difference (P = 0.04) was obtained. Furthermore, the study showed higher amounts of muscles in NHC (P < 0.001).

The amount of TGF-β1 was higher in HC fluid than in non-communicating. To investigate the role of cytokine in the closure of PV, further studies will be required.