Editing Paediatric inguinal hernia (section)

== Treatment ==

* Most hydrocoeles will undergo spontaneous involution by 1 year old
** As long as it doesn't change in size, these can be observed
** Communicating hydrocoele should be repaired electively if it hasn't closed by then
* All other inguinoscrotal abnormalities should be repaired
* Incarcerated
** Resuscitate
** Attempt to reduce - appropriate to be aggressive to prevent testicular ischaemia. Multiple attempts and use of sedation may be necessary. Mostly can be reduced.
** Surgical repair is very difficult - thin and oedematous sac, and risk of damage to cord structures is high. Should be done by paeds surg.
** Herniotomy is the treatment of choice rather than herniorraphy
** If an incarcerated hernia is reduced, repair should be done within the next two days