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The most common childhood swelling in the scrotum is a hydrocoele. A hydrocoele is a collection of fluid in the space in front of the testicle.
In younger children, it usually forms because of a small persistent channel between the abdomen and the scrotum. This is known as a persistent processus vaginalis or PPV for short. This channel allows a small amount of fluid to track downwards and build up in front of the testicle. Sometimes the swelling will come and go and may be more noticeable when the child is crying or straining.
In very young children the PPV may close spontaneously and therefore no treatment is normally indicated until they are 2 years of age. At this point an operation is offered to locate and tie-off the PPV to prevent the fluid tracking downwards and causing the scrotal swelling. This is called a ligation of PPV and is performed through a small incision in the groin as a daycase procedure under a general anaesthetic.
In older children, a persistent processus vaginalis is not usually the problem but hydrocoeles can still occur due to a fluid build up in the space in front of the testicle. These are usually dealt with by an operation through the scrotum to drain the fluid out and then disrupt the hydrocoele sac that contains the fluid.
Patient info – Hydrocele in Children
BAUS – Ligation of a PPV in the groin
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