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Updated: Feb 19, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Scrotal Migration of Tubing: An Unusual Complication after Ventriculo-peritoneal Shunt
Monika Bawa1, Saurabh Garge1, Ravi Garg1
1Department of Pediatric Surgery, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
Scrotal migration of peritoneal end of ventriculo-peritoneal (VP) shunt into the patent processus vaginalis (PPV) is a rare complication. Its exact incidence is not mentioned in the literature till date. This may be because of the rarity of this complication, and also because all previous articles related to the complication were case reports. We, in our series, had an incidence of 0.9%. This prospective study has been conducted on 437 patients in the age group of 1 month-3 years who underwent VP shunt for hydrocephalus over a period of 5 years from 2007 to 2011. The incidence of a hernia manifesting after shunt insertion has been reported to be around 16.8%. The average age of patients at the time of insertion of the shunt was 27.25 months (3-48 months). All our patients presented with swollen right sided scrotum after an average of 4 months (3-5 months) after shunt insertion. Shunt migration was more common on the right which is consistent with the incidence of hernias in children. The proper management of such cases includes repositioning of the catheter with the proper closure of the PPV. Usually, shunt revision is not required. We discuss the etiology, treatment and preventive measures of this rare entity.
Insights
Ventriculo-peritoneal (VP) shunt migration into the scrotum via a patent processus vaginalis (PPV) is a rare complication. This study found a 0.9% incidence in pediatric hydrocephalus patients, with management involving catheter repositioning and PPV closure.
Area of Science:
- Pediatric Neurosurgery
- Surgical Complications
- Hydrocephalus Management
Background:
- Ventriculo-peritoneal (VP) shunts are crucial for managing hydrocephalus in children.
- Complications of VP shunts, though infrequent, require careful consideration.
- Scrotal migration of the peritoneal catheter end into a patent processus vaginalis (PPV) is a rare but documented complication.
Observation:
- A prospective study of 437 pediatric patients (1 month-3 years) undergoing VP shunt insertion for hydrocephalus was conducted over 5 years (2007-2011).
- The incidence of scrotal migration of the VP shunt catheter into the PPV was observed to be 0.9%.
- Patients presented with unilateral scrotal swelling approximately 4 months post-shunt insertion, with a higher incidence on the right side, consistent with pediatric hernia prevalence.
Findings:
- The study identified a specific incidence of 0.9% for VP shunt scrotal migration into the PPV.
- This complication occurred in patients aged 1 month to 3 years, with an average age of 27.25 months at shunt insertion.
- The average time from shunt insertion to presentation of scrotal swelling was 4 months.
Implications:
- The findings highlight the importance of recognizing and managing VP shunt migration into the PPV.
- Effective management involves repositioning the shunt catheter and ensuring proper closure of the PPV, often avoiding the need for shunt revision.
- Understanding the etiology, incidence, and preventive measures is crucial for neurosurgeons managing pediatric hydrocephalus.
