title: The very large recurrent postoperative scrotal hydrocele after pediatric inguinal hernia repair: a rare problem.
abstract: OBJECTIVE
  To report the rare problem of a very large recurrent postoperative scrotal hydrocele after pediatric inguinal hernia repair.
  
  
  METHODS
  From July 1969 to December 2007 inclusive, the charts of five boys mean age 8 years (range 7 months-16 years) with very large recurrent postoperative scrotal hydroceles were reviewed (Research Ethics Board approval 1000007698).
  
  
  RESULTS
  In each case, there was a very large recurrent postoperative symptomatic scrotal hydrocele (3 right, 1 left, 1 bilateral). Their ages at the time of these recurrences were between 11 and 16 years; they were repaired within 2-18 months. The first four were repaired via a groin incision on finding no recurrent inguinal hernia. The last two were repaired through a scrotal approach because a groin ultrasound showed no recurrent inguinal hernia. There was 1 second recurrence which was successfully repaired. A followup of 1(1/2)-9 years revealed no recurrent hydrocele.
  
  
  CONCLUSIONS
  The incidence of a very large recurrent symptomatic postoperative scrotal hydrocele after repair of a pediatric inguinal hernia is 0.06% and usually occurs in older boys. If ultrasonography of the groin is normal (since a recurrent inguinal hernia seems unlikely in such cases), this repair can usually be done via a scrotal approach.
authors.affiliation: Division of General Surgery, Hospital for Sick Children, Toronto, ON, Canada. a_ein@istar.ca
authors.forename: Sigmund Hirsch
authors.initials: SH
authors.lastname: Ein
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nasr
authors.forename: Paul
authors.initials: P
authors.lastname: Wales
authors.forename: Ted
authors.initials: T
authors.lastname: Gerstle
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D006848:Testicular Hydrocele / Q000209:etiology*