Factors affecting the spontaneous resolution of pediatric primary hydrocele: a cohort study of children aged 0–12 years and development of a clinical prediction model

OBJECTIVE: To identify factors influencing the spontaneous resolution of pediatric primary hydrocele (PPH) and construct a predictive nomogram. METHODS: A retrospective analysis was performed on 16 clinical indicators from 449 PPH patients, who were categorized by outcome into the resolution hydroceles (RH) group (n = 215) and the persistent hydroceles (PH) group (n = 234). Indicators showing significant differences in univariate analysis were incorporated into a multivariate binary logistic regression to identify independent risk factors. A nomogram prediction model was subsequently constructed and internally validated. RESULTS: Eight independent factors for resolution were identified (all p < 0.05): bilateral hydrocele (OR = 1.916, 95% CI: 1.155-3.180), older age at diagnosis (OR = 0.989, 95% CI: 0.981-0.998), variable-sized hydrocele (OR = 0.375, 95% CI: 0.241-0.583), positive relevant family history (OR = 0.186, 95% CI: 0.105-0.328), excessive crying during infancy (OR = 0.156, 95% CI: 0.041-0.567), history of functional/organic constipation (OR = 0.169, 95% CI: 0.066-0.434), chronic cough/asthma (OR = 0.361, 95% CI: 0.164-0.791), and abnormal growth status (OR = 0.331, 95% CI: 0.113-0.969). The nomogram showed acceptable discriminatory ability (AUC = 0.798, P < 0.001). CONCLUSION: The identified factors were independently associated with spontaneous resolution of pediatric primary hydrocele. The constructed nomogram demonstrated favorable predictive performance in the study population, although its clinical applicability warrants further validation in external cohorts.