Supplementary Material for: Prevalence of patent processus vaginalis diagnosed using laparoscopy during peritoneal dialysis catheter insertion and subsequent genital edema: A prospective observational study

Introduction: Inguinal hernia and genital edema are relatively common complications of peritoneal dialysis (PD). Although patent processus vaginalis (PV) is considered an important factor associated with these complications, the prevalence of patent PV at PD initiation and whether it leads to these complications have not been fully identified.
Methods: A total of 71 patients were included in this study, 41 of whom underwent laparoscopy-assisted catheter placement. The remaining 30 patients did not undergo laparoscopy mainly because of a lack of patient consent. During laparoscopy, if a dimple or small canal toward the deep inguinal ring was observed, the groin was diagnosed as a patent PV.
Results: Laparoscopy revealed that nine of 41 patients (22%) had patent PV (male, 29.6%; female, 7.1%). Genital edema occurred in two of the nine patients with patent PV at 8.9 and 11.4 months after PD initiation, respectively. However, none of 32 patients without patent PV developed this complication. Two of 30 patients without laparoscopic inspection presented with genital edema at 6.7 and 12.4 months after PD initiation, respectively. Among the 71 patients, body mass index was significantly higher in patients with this complication than in those without (28.8 vs. 22.8, P 0.013).
Conclusion: Although the number of patients with patent PV who manifested genital edema was small, our results suggest that patent PV at PD initiation may be an important contributor for genital edema in patients undergoing PD. Further studies are needed to determine whether the repair of patent PV could prevent subsequent genital edema.

引言：腹膜透析（PD）过程中，腹股沟疝和生殖水肿是相对常见的并发症。尽管开放性鞘状突（PV）被认为是与这些并发症相关的重要因素，但在PD起始阶段开放性PV的普遍性及其是否导致这些并发症尚未得到充分识别。
方法：本研究共纳入71名患者，其中41名接受了腹腔镜辅助导管置入术。剩余的30名患者未接受腹腔镜检查，主要原因是患者拒绝同意。在腹腔镜检查过程中，如果观察到向深腹股沟环方向的凹陷或小管，则将腹股沟诊断为开放性PV。
结果：腹腔镜检查显示，41名患者中有9名（22%）存在开放性PV（男性，29.6%；女性，7.1%）。在PD起始后8.9个月和11.4个月，分别有2名存在开放性PV的患者出现生殖水肿。然而，在无开放性PV的32名患者中，没有人出现这种并发症。在未进行腹腔镜检查的30名患者中，分别有2名在PD起始后6.7个月和12.4个月出现生殖水肿。在71名患者中，出现并发症的患者体重指数显著高于无并发症的患者（28.8 vs. 22.8，P 0.013）。
结论：尽管出现生殖水肿的开放性PV患者数量较少，但我们的研究结果提示，PD起始阶段的开放性PV可能是PD患者发生生殖水肿的重要影响因素。需要进一步研究以确定修复开放性PV是否能预防随后发生的生殖水肿。