Testicular Atrophy Following Unilateral Herniotomy in Children: A Single Centre Experience

Background: A reduction in testicular mass (testicular atrophy) may occur as a complication of hydrocele/hernia repair in children (herniotomy). The aim of this study was to evaluate for testicular atrophy in children who underwent herniotomy for hernia or hydrocele repair. Materials and Methods: This was a prospective study of children aged 15 years and younger who had unilateral herniotomy at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Preoperatively and postoperatively (at least 6 months apart), the volumes of both testes were assessed using ultrasound. These specific testicular volumes were compared to determine the degree of change in unilateral testicular volumes relative to the contralateral testis. For the index study, any reduction in testicular volume of more than 20 percent is considered testicular atrophy. Results: A total of 258 cases of herniotomies were seen during the study period. The mean age of the patients, at diagnosis of testicular atrophy, was 2 years, range of 1 to 3 years. About one-fifth (53) of the patient showed more than 20% reduction in testicular volume relative to the contralateral testis. There were more hydroceles than hernias and all the patients had herniotomy. Stitch related complications were the most common post-operative complication. Conclusion: Herniotomy for pediatric inguinal hernia and hydrocele is one of the most commonly performed surgical procedures in children. However, this procedure is not without complications, testicular atrophy may occur. This study has shown that up to 20% of the children who underwent herniotomy may come down with testicular atrophy.