Abstract Background Hydrocele is a relatively uncommon but clinically significant complication of peritoneal dialysis (PD). However, the risk factors for hydrocele development in patients undergoing PD are unclear so far. Here, we report a series of hydrocele in patients undergoing PD with excessive visceral fat accumulation. Case presentation We report four male patients undergoing PD who developed hydrocele and underwent hernia repair to facilitate continuation of PD. We also analyzed visceral fat accumulation in these patients. The patients were aged 53–74 years, and the underlying kidney diseases were nephrosclerosis ( n = 2) and diabetic kidney disease ( n = 2). All patients presented with scrotal swelling and underwent abdominal computed tomography (CT). CT revealed expansion of the inguinal canal and dialysate leakage into the scrotal cavity, and surgical repair was subsequently performed in all cases. Visceral fat area (VFA) ranged from 115.6 cm 2 to 243.6 cm 2 , and all patients demonstrated excessive visceral fat accumulation. Discussion All four patients showed the hydrocele, and abdominal CT revealed that each patient had visceral fat accumulation greater than 100 cm 2 and evaluation of the inguinal canal from the PD initiation to event onset demonstrated a gradual expansion. These findings suggest that visceral fat accumulation may be associated with progressive enlargement of the inguinal canal and hydrocele development in patients undergoing PD. Conclusions Regular abdominal CT monitoring may help detect hydrocele and inguinal hernia formation, particularly in cases with excessive visceral fat accumulation or other predisposing factors.
Fujii et al. (Tue,) studied this question.