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: Calcium

What It Is

A urine calcium test is done to determine how much of the mineral calcium is being excreted in the urine by the kidneys.

Why It's Done

A urine test for calcium is often done to:

  • help determine the cause of kidney stones and other kidney diseases
  • detect overactivity or underactivity in the parathyroid glands (glands in the neck that produce hormones that help control the level of calcium in the blood)
  • monitor disorders of the kidney and diseases of calcium metabolism

Results may also point to digestive disorders that interfere with the small intestine's ability to absorb nutrients. The urine calcium test is usually used in combination with other tests to make a specific diagnosis.

Preparation

The doctor might prescribe a special diet with high or low levels of calcium for a few days before the test. Your child might need to temporarily stop taking specific drugs, such as antacids, that affect calcium levels in the urine.

The Procedure

Collecting the specimen should only take a few minutes. 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 small catheter may need to be inserted into the bladder to obtain the urine specimen.

Alternatively, a urine collection bag with adhesive tape on one end may be used to collect a sample from an infant. You'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, secure it with the attached tape. You can then put a diaper on your baby. Check your baby's collection bag and remove it after your child has urinated, usually within an hour.

After you bring the sample to the lab, technicians will analyze it for calcium content.

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.

Getting the Results

The results of the urine calcium test are usually available in 1-2 days. Your doctor will go over the results with you and explain what they mean. If abnormalities are found, your doctor may may want to do further tests to make a specific diagnosis.

Risks

Infants may occasionally experience skin irritation from the adhesive tape on the collection bag. If a catheter is used to obtain the urine, it may cause temporary discomfort. If you have any questions or concerns about this procedure, talk to your doctor.

Helping Your Child

Urine collections are usually painless. Explaining how the test will be conducted and why it's being done can help ease any fear. Make sure your child understands that there should be no foreign matter, such as toilet paper or hair, in the sample.

If You Have Questions

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

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