2 minute read
Persistence of the processus vaginalis and its related disorder
Persistence of the processus vaginalis and its related disorder
REVIEWED BY | Allison Holley ASA SIG: Paediatric
REFERENCE | Authors: Brainwood M, Berne G, Fenech M. Journal: Australasian Society for Ultrasound in Medicine. Open Access: Yes
WHY THE STUDY WAS PERFORMED
Persistence of the processus vaginalis can result in a number of congenital pathologies in both the male and female patient. There is little published on the embryology, descent, and the ultimate closure of the processus vaginalis in terms of what can be visualised under ultrasound. Ultrasound-based material is also limited when it comes to differentiation of a spectrum of conditions caused by the different stages of obliteration failure in males. It is worth noting that there is even less written regarding ultrasound involvement with pathologies in the female patient with a persistent canal of Nuck. This article was written to address both these voids.
HOW THE STUDY WAS PERFORMED
Literature review
WHAT THE STUDY FOUND
The article gives a concise, easy-to-follow review of the embryology in both males and females. It clearly discusses the combined role of the processus vaginalis and the gubernaculum in testicular descent in males and goes on to discuss the comparative role of the gubernaculum and canal of Nuck in the location and stabilisation of the ovaries and uterus in the female. The side-by-side comparison of the male processus vaginalis to the female equivalent, the canal of Nuck, highlights the differences and similarities between sexes. The article gives a good description of the stages of obliteration of processus vaginalis and discusses in depth the anomalies that occur when different stages of obliteration fail. The role of ultrasound and the ultrasound appearances of each of the pathologies is discussed. The article also describes the criteria for confirming the presence of a contralateral patent processus vaginalis, which is an important role for ultrasound in the presurgical assessment.
RELEVANCE TO CLINICAL PRACTICE
The article provides excellent tabulated descriptions of the different forms of hydrocele to enable accurate diagnosis and therefore treatment. These descriptions are accompanied by good quality ultrasound images for visual reference and assessment. The table provides an excellent reference chart for correctly classifying the pathologies and would be valuable if displayed in departments for easy reference.
