Inguinal Hernias & Hydroceles

An inguinal (related to the groin) hernia occurs when a part of the intestine protrudes through a weakened spot in the abdominal muscles and into the groin area, while a hydrocele is a fluid-filled sac in the scrotum (the pouch that holds the testes.) Inguinal hernias are more common in boys than girls and tend to occur more often in premature babies.

 
What causes inguinal hernias and hydroceles?

Inguinal hernias and hydroceles are caused by a malformation of the inguinal canal. Before birth, the inguinal canal connects the abdominal cavity (belly) and a child’s normally descending sexual organs. This channel usually closes before or soon after birth, but if the connection remains open, fluid from the abdominal cavity can be trapped in the scrotum in boys and form a hydrocele.

If the connection is large enough, the intestine may be pushed into this space when a child strains causing a protrusion known as a hernia, which may look like a bulge or a lump in your child’s groin area.

 
How are inguinal hernias and hydroceles treated?

The majority of hydroceles go away by themselves by the time your child is 12 to 18 months old.

However, if your child’s hydrocele is very large, changes in size, or persists, or if the hernia can be seen or felt or causes discomfort in your child, your Nemours pediatric urologist may recommend surgical repair. When the hernia bulges out, it is usually soft and not painful to the touch.

If you notice that your child’s hernia is firm, red or tender, you need to call your doctor right away. With hernias, the intestine can become trapped in the hernial sac and cause serious problems, including injury to the intestines and the blood vessels that supply blood to the testes.

Most inguinal hernia and hydrocele repairs are done on an outpatient basis in the operating room and take about one hour. Your Nemours urologist will explain the surgical procedure to you and answer any questions you may have. Recovery time is generally short and your child may be able to take part in usual play activities in a day or so.

Urine Test: Dipstick

What It Is

A urine dipstick test is often done as part of an overall urinalysis, but it can also be done on its own, depending on the doctor's concerns. Once a urine sample is collected, a nurse or technician will place a specially treated chemical strip (dipstick) into your child's urine. Patches on the dipstick will change color to indicate the presence of such things as white blood cells, protein, or glucose.

Why It's Done

The results of a urine dipstick test may point to a diagnosis of urinary tract infection (UTI), kidney disease, diabetes, or a urinary tract injury. If test results are abnormal, other tests will be needed before a definite diagnosis can be made.

Preparation

No preparation other than cleansing the area around the urinary opening is required for the urine dipstick test.

The Procedure

Your child will be asked to urinate into a clean sample cup in the doctor's office. If your child isn't potty trained and can't urinate into a cup, a catheter (a narrow, soft tube) may need to be inserted into the bladder to obtain the urine specimen.

The skin surrounding the urinary opening has to be cleaned and rinsed just before the urine is collected. In this "clean-catch" method, you or your child cleans the skin around the urinary opening with a special towelette. The child then urinates, stops momentarily, and then urinates again into the collection container. Catching the urine in "midstream" is the goal. Be sure to wash your hands and your child's hands after this process.

Once collected, the technician or nurse will then place the dipstick into the urine sample. Collecting the specimen should only take a few minutes.

What to Expect

Because the test involves normal urination; there shouldn't be any discomfort as long as your child can provide a urine specimen. It's important to keep the area around the urinary opening clean before the test and to catch the urine sample midstream.

Getting the Results

The results of the urine dipstick test will be available right away. If abnormalities are found, further urine tests will be needed. Talk to your child's doctor about the meaning of the specific test results.

Risks

No risks are associated with taking a urine dipstick test. If a catheterized specimen is required it may cause temporary discomfort and you can discuss any questions you have about this procedure with your healthcare provider.

Helping Your Child

The urine dipstick test is painless. Explaining how the test will be conducted, and why it's being done, can help ease your child's fear. Make sure your child understands that the urinary opening must be clean and the urine must be collected midstream.

If You Have Questions

If you have questions about the urine dipstick test, speak with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: February 2012