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Definitive identification of a patent processus vaginalis by intraoperative injection of methylene blue into the hydrocoele sac.

Abstract：

OBJECTIVE:Seven percent of patent processus vaginalis (PPVs) are obliterated at exploration. This potentially increases the risk of cord injury with a subsequent increased risk of testicular atrophy or reduced fertility. We report a modification of a technique to improve identification of the PPV and thus potentially minimise the risk to the cord. METHODS:Fifteen consecutive boys were operated on via a standard inguinal approach. The testicle was delivered and 0.2-0.5 ml of a 50% methylene blue/normal saline solution was injected into the hydrocoele sac. A PPV is identified as a blue line. RESULTS:Methylene blue injection identified all PPV. In a case with an encrusted hydrocoele of the cord and a hydrocoele this anatomy was clearly delineated. Dissection in a recurrent case was better facilitated. No testicular atrophy was recorded and there were no significant complications. CONCLUSIONS:Intraoperative injection of a methylene blue solution into a hydrocoele sac will aid identification of a difficult PPV, thus minimising the risk of cord damage. This is especially helpful in cases of recurrent hydrocoele.

journal_name

J Pediatr Urol

journal_title

Journal of pediatric urology

authors

Calleary JG,Wiseman O,Masood J,Hill JT

doi

10.1016/j.jpurol.2007.08.008

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

218-20

issue

3

eissn

1477-5131

issn

1873-4898

pii

S1477-5131(07)00419-6

journal_volume

4

pub_type

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