Needlescopic Management of Hydrocele in Pediatric Age Group; Randomized Controlled Study

Background: Hydrocele is an abnormal collection of fluids along the course of the processus vaginalis due to incomplete obliteration. So, closure of the patent processus vaginalis (PPV) may be the most effective way to prevent recurrence. Traditional open repair entails high ligation of the PPV and draining the fluid or window created in the tunica vaginalis. However, Laparoscopic closure of the internal orifice of the PPV became an option for the treatment of hydroceles in children. Needlescopic hydrocelectomy is considered a novel technique for hydrocelectomy in children. Aim of the study: To evaluate the safety and efficacy of Needelscopic hydrocelectomy in managing congenital hydrocele in children. Patients and Method: An RCT included 40 children with communicating hydrocele attending the Pediatric Surgery Department, Al-Azhar University Hospital in Damietta. The recruited children were equally and randomly separated into two groups (Needlescopic hydrocelectomy and traditional /open method) Results: The present study participants' age ranges from 2 to 7 years. The operative time in the Needlescopic group ranges from 31 to 45 min, with a mean of 37.3 min. In contrast, the open group ranges from 28 to 45 minutes, with a mean of 34.8 minutes (P=0.1). The open group showed a significant incidence of scrotal edema and groin swelling. The Needlescopic group had a significantly higher cosmetic appearance than the open group. Conclusion: Overall, the Needlescopic procedure is simple, safe, and effective in managing hydroceles in the pediatric population.