The Role of Cremaster Muscle as a Cause of Ascending Testis after Inguinal Hernia/Hydrocele Repair

Background ascending testis (at) is one of the rare but serious complication that may occurs following inguinal hernia/hydrocele repair. we aimed to review our more than 7 years’ experience and discuss the possible mechanism through which the at possibly occurs following inguinal hernia/hydrocele repair. materials and methods a retrospective analysis of 7,212 boys who had undergone inguinal hernia/hydrocele repair between march 2009 and april 2016 was conducted. exclusion criteria were: undescended testis, misdiagnosed at, and retractile testis. two types of surgical procedures were performed based on the medical records: (1) transection of the hernia sac and processus vaginalis alone and (2) isolation of the vas deferens and testicular vessels and a global transection of the remaining structures. subsequently, post-operative incidence of at was compared across variables extracted from the medical records. results sixteen (0.22%) patients were diagnosed with at post operatively. at incidence after inguinal hernia/hydrocele repair was reported in approximately 0.19% of the entire patient sample (in the 8491 hernia/hydrocele repairs). comparison of at incidence with the age at initial operation showed significant increase at the age of one year or less (p =0.017). in addition, at incidence was significantly higher in the patients for whom only the sac/processus vaginalis was transected rather than the patients who underwent hernia/hydrocele repair with isolation of the vas deferens and testicular vessels (0.06% vs. 0.27%, respectively, p =0.023). other subgroup analyses remained non-significant.conclusion we conclude that transection of the cremaster muscle might decrease the incidence of ascending testis following inguinal hernia/ hydrocele repair.