Assessment of the Effect of Herniotomy on Testicular Volume in Children

Main Article Content

Chukwubuike Kevin Emeka


Aim: To determine the effect of surgery for hernia or hydrocele in children (herniotomy) on the volume of the testis, using ultrasonography to measure the testicular volume.

Study Design: This was a prospective study of children that had herniotomy for unilateral hernia and hydrocele over a 12-months period.

Place and Duration of Study: Pediatric surgery unit, department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria. 12 months duration.

Methodology: Consecutive children, less than 15 years, who presented during the study period with unilateral inguinal hernia/hydrocele were recruited into the study. The procedure and the study were explained to the parents/caregiver and informed consent obtained. Pre-operative testicular volumes of both testes were measured.  At 12 months post-operatively, repeat testicular volumes were measured to determine if there is any significant change in the volume of the testes. All testicular volumes were measured using ultrasound.

Results: There were 42 unilateral herniotomies performed during the study period. The mean age of the patients was 22.4 ± 18.2 months (range: 4-73 months). There 22 (52.3%) hernias and 20 (47.7%) hydroceles. The overall mean volume of the unilateral testes before herniotomy was 1.7 ± 0.4 cm3 while the overall mean volume of the testes after surgery was 1.4 ± 0.4 cm3, p value = 0.004. For the contralateral testis, the mean pre-operative and post-operative testicular volumes were 1.8 ± 0.5 and 1.9 ± 0.4 cm3 respectively, p value = 0.354. There was one recurrence and one surgical site infection.

Conclusion: There was significant change in testicular volumes following herniotomy for unilateral hernias and hydroceles in children.

Children, hernia, hydrocele, testis, volume

Article Details

How to Cite
Emeka, C. K. (2020). Assessment of the Effect of Herniotomy on Testicular Volume in Children. Asian Journal of Research and Reports in Urology, 3(3), 6-11. Retrieved from
Original Research Article


Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg. 1991;28:407-50.

DOI: 10.1016/0011-3840(91)90028-n

Leung WY, Poon M, Fan TW et al. Testicular volume of boys after inguinal herniotomy: Combined clinical and radiological follow-up. Pediatr Surg Int. 1999;15:40-1.

DOI: 10.1007/s003830050508

Wantz GE. Testicular arophy as a sequela of inguinal hernioplasty. Int Surg. 1986; 71:159-63.

Rafiei MH, Jazini A. Is the ligation of hernia sac necessary in herniotomy for children? A randomized controlled trial of evaluating surgical complications and duration. Adv Biomed Res. 2015;4:97.

Mohta A, Jain N, Irniraya KP, Saluja SS, Sharma S, Gupta A. Non-ligation of the hernia sac during herniotomy: A prospective study. Ped Surgery Int. 2003; 19:451-52.

DOI: 10.1007/s00383-002-0940-y

Sakamoto H, Saito K, Oohta M, Inoue K, Ogawa Y, Yoshida H. Testicular volume measurement: Comparison of ultrasound, orchidometry and water displacement. Urology. 2007;69:152-57.

DOI: 10.1016/j.urology.2006.09.012

Mostafa T, Labib I, El-Khayat Y, El-Rahman El-Shahat A, Gadallah A. Human testicular arterial supply: Gross anatomy, corrosion cast, and radiologic study. Fertility and Sterility. 2008;90:2226-30.

DOI: 10.1016/j.fertnstert.2007.10.013

Hendry WF, Testicular, epididymal and vasal injuries. BJU International. 2000; 86:344-348.

DOI: 10.1046/j.1464-410x.2000.00105.x

Tuncer AA, Peker T, Acar MB, Embleton DB, Cetinkursun S. A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele and cord cyst: A prospective cohort study. Pak J Med Sci. 2017;33:363-368.

DOI: 10.12669/pjms.332.12487

Marinkovic S, Bukarica S, Cvejanov M, Pekovic-Zmic V, Jokic R, Dobanovacki D. Inguinal Herniotomy in prematurely born infants. Med Pregl. 1998;51:228-30.

Sadler GP, Richards H, Watkins G, Foster ME. Day-case paediatric surgery: The only choice. Ann R Coll Surg Engl. 1992;74: 130-33.

Ibrahim M, Getso KI, Mohammad MA. Burden of congenital hernia and hydrocele in northern and southern Nigeria: An opportunity for awareness creation. Afr J Paediatr Surg. 2014;11:312-6.

Dagur G, Gandhi J, Suh Y et al. Classifying hydroceles of the pelvis and groin: An overview of etiology, secondary complications, evaluation and management. Current Urology. 2017;10:1-14.

DOI: 10.1159/000447145.

Lin CC, Huang WJ, Chen KK. Measurement of testicular volume in smaller testes: How accurate is the conventional orchidometer? J Androl. 2009;30:685-9.

DOI: 10.2164/jandrol.108.006460

Anderson AG, Jensen TK, Carlsen E, et al. High frequency of sub-optimal semen quality in an unselected population of young men. Hum Reprod. 2000;15:366-72.

Chikani UN, Ibekwe MU, Chinawa JM, Adimora GN. Testicular volume of healthy term neonates: Determination of normative values among Igbo babies in South-Eastern Nigeria. Niger J Clin Pract. 2016; 19:85-90.

Adaletli I, Kurugoglu S, Kantarci F, et al. Testicular volume before and after hydrocelectomy in children. Journal of Ultrasound in Medicine. 2006;25:1131-36.

DOI: 10.7863/jum.2006.25.9.1131

Sucullu I, Filiz AI, Sen B et al. The effect of inguinal hernia repair on testicular function in young adults: A prospective randomized study. Hernia. 2010;14:165-9.

DOI: 10.1007/s10029-009-0589-8

Gorsler CM, Schier F. Surg Endosc. Laparascopic herniorrhaphy in children. 2003;17:571-3.

Dandapat MC, Padhi NC, Patra AP. Effect of hydrocele on testis and spermatogenesis. BJS. 1990;77:1293-94.

DOI: 10.1002/bjs.1800771132

Singh MP, Goel TC, Agarwal PK, Singh M. Effect of scrotal hydrocele over testicular histology. Indian J Pathol Microbiol. 1989; 32:261-65.

Rados N, Tmski D, Keros P, Rados J. Biomechanical aspect of testis hydrocele. Acta Med Croatica. 1996;50:33-6.

Abatanga F. Groin and scrotal swellings in children aged 5 years and below: A review of 535 cases. Pediatr Surg Int. 2003; 19:446-50.

DOI: 10.1007/s00383-002-0939-4

Mihmanli I, Kantarci F, Kulaksizoglu H, et al. Testicular size and vascular resistance before and after hydrocelectomy. AJR Am J Roentgenol. 2004:183;1379-85.

Yavetz H, Harash B, Yogey L, Homonnai ZT, Paz G. Fertility of men following inguinal hernia repair. Andrologia. 1991; 23:443-6.