Laparoscopic Management of Abdominoscrotal Hydrocele in Children: A Case Series

Background: Abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by a fluid-filled mass with inguinoscrotal and abdominal components. There is a controversy regarding the best management. Objective: This study presented a case series of five boys diagnosed with ASH, three of whom had previous inguinoscrotal surgeries. Laparoscopy was utilized in all patients. Subjects and methods: Patients diagnosed with ASH were treated utilizing either a laparoscopic-assisted or laparoscopic-guided technique. In the laparoscopic-assisted approach, the abdominal cyst was laparoscopically dissected and separated from the vas deferens and testicular vessels. In the laparoscopic-guided approach, laparoscopy was used to confirm the diagnosis and to guide the delivery of the abdominal component and the transfixion ligation of the proximal sac through the inguinal incision. Results: A total of five patients were included with a median age at operation of 55 months (interquartile range: 12-60). Three boys had a history of prior inguinoscrotal surgeries; two for inguinal hernia repair and one for hydrocele. Additionally, one patient presented with bilateral hydrocele and no prior surgical interventions. Furthermore, one patient presented with a provisional diagnosis of right inguinal hernia alongside a left non-palpable undescended testis. Notably, no significant postoperative complications or recurrences were observed among any of the documented cases, with a mean follow-up duration of 17.4 ± 5.18 months. Conclusions: Laparoscopy offers a notably safe and highly efficient method for management of pediatric abdominoscrotal hydrocele, especially in cases where there are instances of recurrence that need to be addressed promptly.