Purpose: To report the rare problem of a very large recurrent postoperative scrotal hydrocele after pediatric inguinal hernia repair.
Methods: From July 1969 to December 2007 inclusive, the charts of five boys mean age 8 years (range 7 months-16 years) with very large recurrent postoperative scrotal hydroceles were reviewed (Research Ethics Board approval 1000007698).
Results: In each case, there was a very large recurrent postoperative symptomatic scrotal hydrocele (3 right, 1 left, 1 bilateral). Their ages at the time of these recurrences were between 11 and 16 years; they were repaired within 2-18 months. The first four were repaired via a groin incision on finding no recurrent inguinal hernia. The last two were repaired through a scrotal approach because a groin ultrasound showed no recurrent inguinal hernia. There was 1 second recurrence which was successfully repaired. A followup of 1(1/2)-9 years revealed no recurrent hydrocele.
Conclusions: The incidence of a very large recurrent symptomatic postoperative scrotal hydrocele after repair of a pediatric inguinal hernia is 0.06% and usually occurs in older boys. If ultrasonography of the groin is normal (since a recurrent inguinal hernia seems unlikely in such cases), this repair can usually be done via a scrotal approach.