Prevalence of Patent Processus Vaginalis Diagnosed Using Laparoscopy during Peritoneal Dialysis Catheter Insertion and Subsequent Genital Edema: A Prospective Observational Study.

Abstract

Introduction: Inguinal hernia and genital edema are relatively common complications of peritoneal dialysis (PD). Although patent processus vaginalis (PV) is considered an important factor associated with these complications, the prevalence of patent PV at PD initiation and whether it leads to these complications has not been fully identified.

Methods: A total of 71 patients were included in this study, 41 of whom underwent laparoscopy-assisted catheter placement. The remaining 30 patients did not undergo laparoscopy mainly because of a lack of patient consent. During laparoscopy, if a dimple or small canal toward the deep inguinal ring was observed, the groin was diagnosed as a patent PV.

Results: Laparoscopy revealed that 9 of 41 patients (22%) had patent PV (male, 29.6%; female, 7.1%). Genital edema occurred in 2 of the nine patients with patent PV at 8.9 and 11.4 months after PD initiation, respectively. However, none of 32 patients without patent PV developed this complication. Two of 30 patients without laparoscopic inspection presented with genital edema at 6.7 and 12.4 months after PD initiation, respectively. Among the 71 patients, body mass index was significantly higher in patients with this complication than in those without (28.8 vs. 22.8, p 0.013).

Conclusion: Although the number of patients with patent PV who manifested genital edema was small, our results suggest that patent PV at PD initiation may be an important contributor for genital edema in patients undergoing PD. Further studies are needed to determine whether the repair of patent PV could prevent subsequent genital edema.