A small lump was first observed in Manh's right groin when he was 5 months old. Doctors advised monitoring the lump, suggesting it might resolve on its own after one year of age. For over a month, the skin around the boy's genitals became inflamed and red, and the lump grew significantly, prompting his family to seek treatment at Tam Anh General Hospital Ho Chi Minh City.

Dr. Nguyen Do Trong, a pediatric surgeon, stated that the patient had a fluid sac nearly 5 cm in size along his right groin, with no evidence of herniated bowel loops or omentum. Doctors diagnosed Manh with an encysted hydrocele of the right spermatic cord. He required surgery to remove the fluid sac and close the patent processus vaginalis to prevent fluid reaccumulation and complications such as inguinal hernia or testicular compression.

Dr. Trong (second from right) and the surgical team operate on Manh. Photo: Tam Anh General Hospital

Surgeons made a small incision, about 1.5-2 cm, at the right lower abdominal crease to access the inguinal canal, expose the spermatic cord vascular bundle, and identify the fluid-filled cyst. They dissected the cyst from the testicular artery, testicular vein, and vas deferens. The fluid sac was then ligated high near the deep inguinal ring and excised, completely addressing the persistent communication. After confirming no accompanying herniated organs, Dr. Trong closed the abdominal wall in layers with absorbable sutures, ensuring a good cosmetic outcome.

According to Dr. Trong, a spermatic cord cyst forms when the processus vaginalis, a structure connecting the abdominal cavity to the scrotum during fetal development, fails to close completely after birth. The condition is common in children, especially those under two years old.

Common symptoms include a lump in the groin or scrotum, with one side appearing larger than the other, minimal pain, and no fever. Since children often eat and sleep normally, most parents easily mistake it for diaper rash or common swelling.

MSc. Dr. Ton Thi Anh Tu, pediatric surgeon, examines Manh and advises the family on wound care. Photo: Tam Anh General Hospital

Without treatment, the cyst can continue to enlarge, causing pressure, discomfort, and recurrent skin inflammation in the groin and scrotum. In some cases, the condition is accompanied by an inguinal hernia. If a bowel loop descends into the scrotum, it risks incarceration, requiring emergency surgery. Prolonged compression can also affect future testicular development.

Following surgery, Manh recovered quickly, with stable vital signs, a dry incision, minimal pain, and resumed normal activities. He was discharged on the same day.

Dr. Trong advised parents to keep the child's incision dry and clean during the initial days after surgery, dress the child in loose clothing, and limit vigorous activity for about one to two weeks. If the incision shows significant swelling or redness, discharges fluid, or if the child develops a fever or unusual fussiness, parents should bring the child to the hospital for an early check-up.

Minh Tam

*Patient's name has been changed