Patent Processus Vaginalis in Pediatric Communicating Hydroceles: To ligate or not to ligate

Background High ligation of the patent processus vaginalis (PPV) is conventionally performed for communicating hydroceles, as it is believed to decrease the likelihood of recurrence. Objective To compare complication rates in children who had excision and ligation of PPV and those who had excision without ligation of PPV during surgery for communicating hydrocele. Methods The study was a prospective randomized study of children with communicating hydroceles. Participants were randomized into two groups: ligation and non-ligation. Postoperative complications were systematically documented. Data were entered and analyzed using IBM SPSS Statistics version 21. Results were presented as percentages and in tabular form. The Student's t-test was applied for comparisons of quantitative variables, while the Chi-square test was used for qualitative variables. A p-value less than 0.05 was considered statistically significant. Results Sixty-eight patients (65males) with 70 communicating hydroceles (two bilateral hydroceles) aged 1 year to 15 years were used. Three patients had scrotal hematoma(4.3%). Of these, 2(2.9%) occurred in non-ligation group and 1(1.4%) in Ligation group ( p =  0.56). The scrotal hematoma resolved over 14–21 days. The mean duration of surgery for Non-ligation group was 32.8 ± 5.1 minutes; the Ligation group, 34.4 ± 9.8 minutes, and they were comparable. ( p  = 0.394). There was no recurrence and no development of an inguinal hernia. Conclusion There is no significant difference in complication rates between the ligation and non-ligation of a patent processus vaginalis in pediatric communicating hydroceles.