Laparoscopic transabdominal preperitoneal repair of a hydrocele of the canal of Nuck in an adult woman

TL;DR

A rare case of a hydrocele in an adult woman was successfully treated using a laparoscopic surgical approach.

Contribution

The paper presents a successful laparoscopic transabdominal preperitoneal repair for a rare adult hydrocele of the canal of Nuck.

Findings

Laparoscopic transabdominal preperitoneal repair successfully treated a symptomatic hydrocele of the canal of Nuck in a 44-year-old woman.

Cross-sectional imaging confirmed the diagnosis and guided the surgical approach.

Pathological analysis of the excised hydrocele is recommended to rule out malignancies.

Abstract

Hydrocele of the canal of Nuck is a rare pathology seen in adult women. Homologous with the processus vaginalis in men, pathologies of the canal of Nuck arise from a failure of obliteration of this tract. More commonly they present in children but rarely manifest in adults typically presenting as a painful lump which can be difficult to distinguish clinically from hernias. Cross-sectional imaging is key in diagnosis and surgery is the mainstay of treatment as it allows of excision of the hydrocoele and reinforcement of the defect to prevent subsequent hernias. While often the pathology is benign, malignancies have been documented and once excised the hydrocele should undergo pathological analysis to exclude such malignancies. Herein we present the case of a 44-year-old women who presented with a symptomatic hydrocele of the canal of Nuck confirmed on imaging that was successfully treated with a laparoscopic transabdominal preperitoneal approach.

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