Comparison of Testicular Volume and Blood Flow in Children Before and After Surgery for Inguinoscrotal Diseases- A Prospective Cohort Study

Abstract

Introduction: Testicular diseases in children include hernia, hydrocele, undescended testis, epididymal cyst or torsion testis. Some of these like hernia and undescended testis will have affect on the testicular volume and blood flow. These are predictors for the future function of the testis. Manipulations during surgery can also affect blood flow to the testis. Aim: To compare testicular volume and blood flow in children undergoing surgery for inguinoscrotal diseases in both normal and diseased sides, before and after surgery. Materials and Methods: A prospective cohort study was conducted from March 2019 to December 2019 in which 30 children were selected from Surgery Outpatient Department (OPD), Department of Paediatrics, Gian Sagar Medical College, Rajpura, Punjab, India. For patients having inguinoscrotal disease, ultrasonography (US) and colour doppler was done preoperatively on all cases by an experienced radiologist, using the same machine settings on the seventh day and three months postsurgery. Preoperative and postoperative testicular volume and blood flow was recorded in all the patients. The Statistical Package for Social Sciences (SPSS) software was used to statistically analyse the data arising, p<0.05 was accepted as statistically significant. Results: Total of 30 children (10 months to 10 years of age) formed the total sample of the study. Pathology was found in 18 patients on the right side and 12 patients on the left side. When the right and left side pathology were compared, it was found that right testicular volume was less as compared to left side. This difference was statistically significant with the p-value 0.006. There was a significant difference in blood flow between the right and left testis, both before (p-value 0.007) and after surgery (p-value=0.004). Testicular volume increased three months postsurgery in all the patients. This difference was more evident in left side pathology (p<0.05) as compared to right side (p>0.05). The increase in mean blood flow of diseased testis was significant after seven days of surgery (p-value <0.05). But change in mean testicular volume and blood flow after three months of follow-up was found to be non-significant. Conclusion: Inguinal surgery does not affect the testicular volume and blood flow. But long term follow-up for children of inguinal surgery for its effect on fertility should be evaluated.