Infant hydroceles are usually the result of peritoneal fluid that accumulates in the scrotum. This can be either via a patent processus vaginalis (communicating hydrocele), or by a nonpatent processus that has trapped a significant amount of peritoneal fluid, causing a scrotal bulge. The most important differential between the two is that the size of the scrotal mass changes with recumbency, or with crying, in the case of communicating hydroceles. Most communicating hy-droceles tend to close within the 1st year of life, so surgical repair should be delayed to 1 year of life. An inguinal approach to surgical ligation should be used. In the case of premature infants, however, surgical repair should be performed before discharge from the hospital because of the risk of bowel herniation (Benjamin 2002).
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