Paper Information

Journal:   INTERNATIONAL JOURNAL OF PEDIATRICS   May 2017 , Volume 5 , Number 5 (41); Page(s) 4919 To 4928.
 
Paper: 

The Role of Cremaster Muscle as a Cause of Ascending Testis after Inguinal Hernia/Hydrocele Repair

 
 
Author(s):  Salimi Amrollah, Rashidinia Shervin, Shahmoradi sara, Eftekhari Seyed Shahin*
 
* Student Research Committee, Qom University of Medical Sciences, Qom, Iran
 
Abstract: 
Background Ascending testis (AT) is one of the rare but serious complication that may occurs following inguinal hernia/hydrocele repair. We aimed to review our more than 7 years’ experience and discuss the possible mechanism through which the AT possibly occurs following inguinal hernia/hydrocele repair. Materials and Methods A retrospective analysis of 7, 212 boys who had undergone inguinal hernia/hydrocele repair between March 2009 and April 2016 was conducted. Exclusion criteria were: undescended testis, misdiagnosed AT, and retractile testis. Two types of surgical procedures were performed based on the medical records: (1) transection of the hernia sac and processus vaginalis alone and (2) isolation of the vas deferens and testicular vessels and a global transection of the remaining structures. Subsequently, post-operative incidence of AT was compared across variables extracted from the medical records. Results Sixteen (0. 22%) patients were diagnosed with AT post operatively. AT incidence after inguinal hernia/hydrocele repair was reported in approximately 0. 19% of the entire patient sample (in the 8491 hernia/hydrocele repairs). Comparison of AT incidence with the age at initial operation showed significant increase at the age of one year or less (P =0. 017). In addition, AT incidence was significantly higher in the patients for whom only the sac/processus vaginalis was transected rather than the patients who underwent hernia/hydrocele repair with isolation of the vas deferens and testicular vessels (0. 06% vs. 0. 27%, respectively, P =0. 023). Other subgroup analyses remained non-significant. Conclusion We conclude that transection of the cremaster muscle might decrease the incidence of ascending testis following inguinal hernia/ hydrocele repair.
 
Keyword(s): Ascending testis,Cremaster muscle,Inguinal hernia
 
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