OCCULT INGUINAL-HERNIA, A CAUSE OF RAPID ONSET OF PENILE AND SCROTAL EDEMA IN PATIENTS ON CHRONIC PERITONEAL-DIALYSIS

From 1976 to 1993 we inserted 160 chronic peritoneal dialysis catheter s for renal failure patients, Three of these patients developed sudden onset of penile and scrotal edema after the catheter had been in plac e for several months, The first patient was diagnosed by instilling te chnetium sulfur colloid in the peritoneal cavity, which showed the rad ioisotope flowing via the right inguinal canal, He was operated on and the processus vaginalis was tied off and the scrotal and penile edema resolved. Subsequently, two more patients were seen with similar prob lems and had their inguinal canals explored and the processus vaginali s in one and the hernia sac in the other were found and tied off, whic h resulted in resolution of the problem. This is an uncommon complicat ion, reported to occur in 3 to 4% of patients.