Ipsilateral and contralateral patent processus vaginalis in pediatric patients with a unilateral nonpalpable testis

This study aimed to investigate the incidence of patent processus vaginalis(PPV)in pediatric patients with a unilateral nonpalpable testis and explore the associated factors.From May 2014 to April 2017,152 boys who were diagnosed with a unilateral nonpalpable testis and underwent laparoscopy in Shanghai Children’s Hospital(Shanghai,China)were included in this study.The data were collected and reviewed,and the results were analyzed regarding the age at operation,side,development,and position of the nonpalpable testis.The mean age of the patients was 2.6(standard deviation:2.3)years.The testis was absent in 14 cases,nonviable in 81 cases,and viable in 57 cases.The incidence of PPV was 37.5%(57 of 152)on the ipsilateral side and 16.4%(25 of 152)on the contralateral side.The ipsilateral PPV was more prevalent when the nonpalpable testis occurred on the right side(P<0.01).Besides,patients with a viable testis had a greater incidence of ipsilateral PPV than those with a nonviable or absent testis(P<0.01).Moreover,this rate was the highest when the testis was in the abdominal cavity and the lowest when the testis was in the scrotum(both P<0.01).However,the incidence of contralateral PPV was independent of all the factors.In conclusion,in children with a nonpalpable testis,the incidence of an ipsilateral PPV was significantly related to the side,development,and position of the testis,while it was independent of these factors on the contralateral side.

Incidence and Concurrent Laparoscopic Repair of ypertrophic Pyloric Stenosis and Patent Processus Vaginalis

INTRODUCTIONAlthough laparoscopic herniorrhaphy is the most common procedure performed by pediatric surgeons at present, herniorrhaphy with an asymptomatic patent processus vaginalis （PPV） remains controversial. The incidence of contralateral PPV on laparoscopy in previous studies was reported as 20%-50%, but it is believed to approach 100% in premature infants. It has been reported that 4%-34% patients have the risk of developing subsequent metachronous contralateral hernia after a repair of an ipsilateral hernia.Iu If this is true, then the identification and closure of a PPV at the time of ipsilateral hernia repair will obviate the need for a second operation in thousands of children every year. With recent advances in minimally invasive surgery, transinguinal diagnostic laparoscopy has emerged as a safe and effective method for evaluating a pediatric patient with PPV. Meanwhile, the laparoscopy has been widely used to manage the infantile hypertrophic pyloric stenosis （IHPS）, due to equally high success rate, minimal complications, and a shorter hospital stay.