An examination at Tam Anh General Hospital Hanoi revealed that Khanh's foreskin was long and constricted. Both sides of his scrotum had descended, with the right side significantly more swollen and fluid-filled, causing asymmetry. Ultrasound and specialized evaluation confirmed that the boy had bilateral patent processus vaginalis, leading to bilateral hydrocele.

According to Master of Science, Doctor Le Minh Hung from the Urology - Andrology Department, the patent processus vaginalis is a structure present during the fetal stage. It serves as the pathway for the testes to descend from the abdomen into the scrotum and typically closes spontaneously after birth. If the passage remains open, abdominal fluid can descend into the scrotum, causing hydrocele, or create a communication that allows intestines to protrude, leading to an inguinal hernia. This condition occurs in approximately 1/1,000 newborns and 1/294 children aged 7-12.

Doctor Hung noted that Khanh's case was complex due to bilateral patent processus vaginalis, yet initial symptoms were unclear and could easily be mistaken for common swelling. Without early treatment, fluid could continue to accumulate, causing the scrotum to become increasingly tense and enlarged, thereby raising the risk of an inguinal hernia and potential testicular damage.

A laparoscopic surgical team closed the patent processus vaginalis to sever the abnormal connection between the abdomen and scrotum. This prevents further fluid accumulation, which causes hydrocele, and guards against future inguinal hernia risk. The laparoscopic method is preferred for its ability to provide a complete view of the inguinal-scrotal region, allowing doctors to assess both sides simultaneously and minimize missed lesions.

The surgical team closes the patent processus vaginalis for the child. *Photo: Tam Anh General Hospital*

Following the intervention, the child's genital area showed significantly reduced swelling and improved symmetry. Khanh ate and moved normally, recovering well at a one-week follow-up appointment.

Doctor Hung advises parents to seek medical attention if a child's scrotum exhibits unusual enlargement, one side hangs lower than the other, asymmetry, or prolonged size changes, even if the child experiences no pain or fever. Early detection and treatment help limit the risk of inguinal hernia and other complications.

By Thu Giang

*Patient's name has been changed