A 6-week-old male infant has a scrotal swelling that is soft, transilluminates, and is present since birth. It does not extend to the inguinal canal and does not change with crying. What is the most appropriate management?
- A Observation until 18–24 months; 80% resolve spontaneously ✓
- B Urgent surgical exploration to exclude testicular torsion
- C Aspiration of the hydrocele fluid
- D Ligation of the patent processus vaginalis at 6 months
Correct answer: A. Observation until 18–24 months; 80% resolve spontaneously
Explanation
A communicating hydrocele in a neonate represents a patent processus vaginalis and typically resolves spontaneously by 18–24 months of age as the processus closes. Current guidelines recommend observation without intervention during the first 2 years provided it is non-communicating (no size change with position/Valsalva) or mildly communicating. Surgical repair is indicated if it persists beyond 18–24 months or becomes communicating. Aspiration has high recurrence and risks infection.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.