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: Creatinine

What It Is

Creatinine is a waste product that the muscles produce at a steady rate as part of normal daily activity. The bloodstream carries creatinine to the kidneys, which filter it out of the blood, and it is passed out of the body in urine.

A urine creatinine test measures the amount of creatinine in the urine. It can be done on its own or with other tests that determine the relative amounts of other substances being excreted in the urine.

Why It's Done

Healthy kidneys filter the blood to rid it of waste products that the body can't use. Low levels of creatinine in the urine may point to a kidney disease, certain muscular and neuromuscular disorders, or an obstruction of the urinary tract. If test results are abnormal, other tests will be done to make a specific diagnosis.

A creatinine clearance test measures the blood creatinine level as well as how much creatinine is being passed in the urine over several hours. This gives doctors information about how well the kidneys are functioning.

A doctor may order a urine creatinine test in combination with other urine tests even when no kidney dysfunction is suspected. Because creatinine is filtered out at a fairly steady rate, doctors compare the creatinine level with levels of other substances in the urine to determine if they're being excreted at a normal rate.

Preparation

Your child might need to temporarily stop taking certain drugs that affect the urine's creatinine levels and might be asked to not eat large quantities of meat in the day or two before the test.

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.

If you collect the specimen at home, follow any storage and transportation instructions the lab gives you.

For a creatinine clearance test, you'll need to collect all the urine your child passes over a period of several hours (usually 24 hours). This usually involves first getting a special container from the lab in which to collect the urine, plus specific instructions about how to collect and store the timed urine sample.

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

In general, the results of the urine creatinine test are available within a day or two. Your doctor will go over the results with you and explain what they mean. If abnormalities are found, further tests may be needed.

Risks

No risks are associated with taking a urine creatinine test.

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

Collecting the specimen for a urine creatinine test is 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 creatinine test, speak with your doctor.

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