Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study
Topic overview
Multi-center prospective study of 526 infants undergoing laparoscopic pyloromyotomy found 54% had a patent processus vaginalis, more common in younger, lower-weight infants. Despite high PPV prevalence, only 1.2% required hernia repair within first year, suggesting most PPVs may not require prophylactic intervention.
Key takeaways
- PPV prevalence is 54% in infants undergoing pyloromyotomy, with bilateral PPV in 47% of cases and right-sided predominance (41% vs 12% left)
- PPV presence correlates with younger age, lower weight, and lower gestational age at birth in this cohort
- Only 1.2% of infants with documented PPV required hernia repair within first year, suggesting most PPVs do not become symptomatic early
- Routine prophylactic repair of asymptomatic PPV at pyloromyotomy may not be warranted given low early hernia rate
- Long-term follow-up beyond infancy is needed to determine true lifetime hernia risk in patients with documented PPV
Comments