Introduction: Patients undergoing circumcisions with concomitant inguinal pathologies currently require both a penile and inguinal incision. We have previously described performing inguinal procedures through a penile incision. Herein we extend on this minimally invasive approach by performing a hydrocelectomy through a circumcision incision. Methods: Once the preputial skin is excised, the penopubic junction is bluntly dissected. An S-shaped retractor is placed on the pubic bone and retracted towards the ipsilateral shoulder. With the pubic bone as a key landmark, the cord structures are carefully identified and the hydrocele sac is dissected off. The circumcision is then completed in the usual fashion. Results: To date, we have offered this approach to all children undergoing circumcision and who also have undescended testis (UDT), hydroceles, or hernias. We have found that this approach is best for children who are under 5 years of age. Notably, this approach does not affect the appearance of the circumcision in any way. Conclusions: Children with inguinal pathologies, such as UDT, hernias or hydroceles, who are also undergoing circumcision or any penile procedure are currently offered this approach. A single penile incision for circumcision and correction of inguinal pathology is feasible, safe, and provides similar surgical outcomes with shorter overall operative time. SOURCE OF Funding: None
