Risk of Scrotal Hydroceles After Nephrectomy For Kidney Cancer

NCT07527637 | Completed

• 1 other identifier: 2026 0906 626 002
• Study Type: observational
• Target: 40,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

This population-based study will use provincial health administrative data to examine the risk of hospital admission for hydrocelectomy among males who underwent nephrectomy for kidney cancer, compared with males from the general population with similar baseline health characteristics, who did not undergo nephrectomy. We will use health administrative data from Ontario, Canada, to identify males who underwent nephrectomy for kidney cancer between 1992 and 2024. Four surgical cohorts will be constructed based on procedure type and surgical approach: laparoscopic total nephrectomy, open total nephrectomy, laparoscopic partial nephrectomy, and open partial nephrectomy. A propensity score will be calculated based on sociodemographic characteristics, comorbidities, and health care utilization. For each surgical cohort, patients will be matched to non-nephrectomy male controls (1:4) based on propensity score, age, index date, and modified Charlson Score (excluding cancer). The primary analysis will compare patients undergoing laparoscopic total nephrectomy and laparoscopic partial nephrectomy with matched non-nephrectomy controls from the general population. The primary outcome is hospital admission for hydrocelectomy. Secondary outcomes include diagnosis of hydrocele with receipt of a scrotal ultrasound, and receipt of a scrotal ultrasound. Additional analyses will compare surgical approaches.

Conditions

Hydrocele; Hydrocele of Tunica Vaginalis; Hydrocelectomy; Nephrectomy; Laparoscopic Nephrectomy; Kidney Cancers

Keywords

laparoscopic; nephrectomy; hydrocele; hydrocelectomy; kidney cancer

Outcome Measures

Primary Outcomes (1)

• Hydrocelectomy

  A hospital-based procedural code (CCI code: 1QH87LA, 1QH87LB, 1QH52HA, 1QH52LA, 1QH80LA, 1QG52HA, 1QG52LA; CCP code: 731, 730, 7391, 7339) and a surgeon-fee-for-service code (OHIP fee code: S611, S630) within 30 days.

  Follow-up period (index date to outcome, emigration, or maximum follow-up date [March 31, 2025]).

Secondary Outcomes (2)

• Hydrocele diagnosis

  Follow-up period (index date to outcome, emigration, or maximum follow-up date [March 31, 2025]).

• Scrotal ultrasound

  Follow-up period (index date to outcome, emigration, or maximum follow-up date [March 31, 2025]).

Study Arms (5)

Laparoscopic total nephrectomy

Males who underwent laparoscopic total nephrectomy for kidney cancer between July 1, 1992 and March 31, 2024. Surgeon-fee-for-service code (OHIP fee code: E792, S413, S416, with no evidence of E766, E767, E768, S424, S420) and a hospital-based procedural code (CCI: 1PC89DA, 1PC91DA; CCP: 674, 6741, 6742, 6744).

Procedure: Laparoscopic nephrectomy for kidney cancer

Laparoscopic partial nephrectomy

Males who underwent laparoscopic partial nephrectomy for kidney cancer between July 1, 1992 and March 31, 2024. Surgeon-fee-for-service code (OHIP fee code: S411, S423) and a hospital-based procedural code (CCI: 1PC87DA; CCP: 673).

Procedure: Laparoscopic nephrectomy for kidney cancer

Open total nephrectomy

Males who underwent open total nephrectomy for kidney cancer between July 1, 1992 and March 31, 2024. Surgeon-fee-for-service code (OHIP fee code: S413, S415, S416, with no evidence of E792, E766, E767, E768, S424, S420) and a hospital-based procedural code (CCI: 1PC89LB, 1PC89PF, 1PC89QF, 1PC91LB, 1PC91PF, 1PC91QF; CCP: 674, 6741, 6742, 6744).

Procedure: Open nephrectomy for kidney cancer

Open partial nephrectomy

Males who underwent open partial nephrectomy for kidney cancer between July 1, 1992 and March 31, 2024. Surgeon-fee-for-service code (OHIP fee code: S411, S423) and a hospital-based procedural code (CCI: 1PC87LA, 1PC87LAXXE, 1PC87LAXXG, 1PC87NQ; CCP: 673).

Procedure: Open nephrectomy for kidney cancer

Non-nephrectomy controls

Males from the general Ontario population who did not undergo any nephrectomy.

Interventions

Laparoscopic nephrectomy for kidney cancer PROCEDURE

Receipt of a laparoscopic (total or partial) nephrectomy for kidney cancer

Laparoscopic partial nephrectomy; Laparoscopic total nephrectomy

Open nephrectomy for kidney cancer PROCEDURE

Receipt of an open (total or partial) nephrectomy for kidney cancer

Open partial nephrectomy; Open total nephrectomy

Eligibility Criteria

• Age: 0 Years - 105 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Male residents of Ontario, Canada identified through provincial administrative health databases who underwent nephrectomy for kidney cancer between July 1, 1992 and March 31, 2024, along with matched non-nephrectomy controls from the general population.

You may qualify if:

• Male individuals who underwent laparoscopic complete/total nephrectomy between July 1, 1992, and March 31, 2024, with a most responsible diagnosis of malignant kidney, renal pelvis, or ureter cancer at the time of nephrectomy. The index date is defined as the date of the first laparoscopic total nephrectomy during the study period.

You may not qualify if:

• Individuals with data record errors (e.g., missing or invalid age, sex, or date of birth), who are less than 0 years of age or greater than 105 years of age, with a death record on or before their cohort entry, or have a date of last contact \<4 months after cohort entry (to restrict to permanent residents of the province).
• Prior partial nephrectomy at any time in the lookback.
• Prior total nephrectomy before the start of accrual (before July 1, 1992).
• Individuals who underwent conversion from laparoscopic to open nephrectomy during the same surgical episode.
• Individuals with no recorded primary care visit in the year prior to the index date.
• History of scrotal or male genital conditions or procedures prior to the index date, including hydrocele, hydrocelectomy, scrotal ultrasound, scrotal or testicular malignancy, or other scrotal/genital procedures.
• \*Laparoscopic partial nephrectomy\*
• Male individuals who underwent laparoscopic partial nephrectomy between July 1, 1992 and March 31, 2024, with a most responsible diagnosis of malignant kidney, renal pelvis, or ureter cancer at the time of nephrectomy. The index date is defined as the date of the first laparoscopic partial nephrectomy during the study period.
• Individuals with data record errors (e.g., missing or invalid age, sex, or date of birth), who are less than 0 years of age or greater than 105 years of age, with a death record on or before their cohort entry, or have a date of last contact \<4 months after cohort entry (to restrict to permanent residents of the province).
• Prior total nephrectomy at any time in the lookback.
• Any nephrectomy before the start of accrual (before July 1, 1992).
• Individuals who underwent conversion from laparoscopic to open nephrectomy during the same surgical episode.
• Individuals with no recorded primary care visit in the year prior to the index date.
• History of scrotal or male genital conditions or procedures prior to the index date, including hydrocele, hydrocelectomy, scrotal ultrasound, scrotal or testicular malignancy, or other scrotal/genital procedures.
• \*Open total nephrectomy\*

Sponsors & Collaborators

• London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's: lead

Related Publications (13)

• Garg AX, McArthur E, Sontrop JM, Boudville N, Connaughton DM, Cuerden MS, Feldman LS, Lam NN, Lentine KL, Nguan C, Parikh CR, Segev DL, Sener A, Smith G, Wang C, Weir MA, Yohanna S, Young A, Naylor KL. Risk for Scrotal Surgery After Laparoscopic Donor Nephrectomy : A Population-Based Cohort Study. Ann Intern Med. 2026 Jan;179(1):23-31. doi: 10.7326/ANNALS-25-02257. Epub 2025 Nov 11.

  PMID: 41213151 BACKGROUND

• Gjertson CK, Sundaram CP. Testicular pain following laparoscopic renal surgery. J Urol. 2008 Nov;180(5):2037-40; discussion 2040-1. doi: 10.1016/j.juro.2008.07.045. Epub 2008 Sep 18.

  PMID: 18804234 BACKGROUND

• Choi SW, Moon HW, Kim KS, Choi YS, Cho HJ. Testicular Pain Following Laparoscopic Donor Nephrectomy: An Underreported Complication. J Endourol. 2024 Dec;38(12):1340-1345. doi: 10.1089/end.2024.0454. Epub 2024 Sep 16.

  PMID: 39212680 BACKGROUND

• Garg AX, Feldman LS, Sontrop JM, Cuerden MS, Arnold JB, Boudville N, Karpinski M, Klarenbach S, Knoll G, Lok CE, McArthur E, Miller M, Monroy-Cuadros M, Naylor KL, Prasad GVR, Storsley L, Nguan C. Testicular Pain After Living Kidney Donation: Results From a Multicenter Cohort Study. Can J Kidney Health Dis. 2025 Mar 29;12:20543581251324610. doi: 10.1177/20543581251324610. eCollection 2025.

  PMID: 40161413 BACKGROUND

• Shirodkar SP, Gorin MA, Sageshima J, Bird VG, Martinez JM, Zarak A, Guerra G, Chen L, Burke GW, Ciancio G. Technical modification for laparoscopic donor nephrectomy to minimize testicular pain: a complication with significant morbidity. Am J Transplant. 2011 May;11(5):1031-4. doi: 10.1111/j.1600-6143.2011.03495.x.

  PMID: 21521470 BACKGROUND

• Sureka SK, Srivastava A, Agarwal S, Srivastava A, An S, Singh S, Mittal V, Patidar N, Kapoor R, Ansari MS. Prevention of Orchialgia After Left-Sided Laparoscopic Donor Nephrectomy-A Prospective Study. J Endourol. 2015 Jun;29(6):696-9. doi: 10.1089/end.2014.0645. Epub 2015 Jan 28.

  PMID: 25401724 BACKGROUND

• El Hennawy HM, Al Faifi AS, Al Atta E, Safar O, Thamer S, El Nazer W, Kamal AI, Abdelaziz AA, Kawasmeh SA, Mirza N, Zaitoun MF, Al-Alsheikh K, Shalkamy O, Mahedy A. Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature. Minim Invasive Surg. 2022 Mar 23;2022:3292048. doi: 10.1155/2022/3292048. eCollection 2022.

  PMID: 35721390 BACKGROUND

• Pinar U, Pettenati C, Hurel S, Pietak M, Dariane C, Audenet F, Legendre C, Rozenberg A, Mejean A, Timsit MO. Persistent orchialgia after laparoscopic living-donor nephrectomy: an underestimated complication requiring information adjustment. World J Urol. 2021 Feb;39(2):621-627. doi: 10.1007/s00345-020-03228-6. Epub 2020 May 3.

  PMID: 32363451 BACKGROUND

• Schoephoerster J, Matas A, Jackson S, Pruett TL, Finger E, Kandaswamy R, Dunn T, Kirchner V, Anderson JK, Humphreville V. Orchialgia After Living Donor Nephrectomy: An Underreported Entity. Transplant Direct. 2022 Oct 24;8(11):e1383. doi: 10.1097/TXD.0000000000001383. eCollection 2022 Nov.

  PMID: 36299443 BACKGROUND

• Srivastava A, Kapoor R, Srivastava A, Ansari MS, Singh M, Kapoor R. Orchialgia after laproscopic renal surgery: a common problem with questionable etiology. Are there any predictors? World J Urol. 2013 Oct;31(5):1153-7. doi: 10.1007/s00345-012-0864-7. Epub 2012 Apr 15.

  PMID: 22527670 BACKGROUND

• Chin EH, Hazzan D, Herron DM, Gaetano JN, Ames SA, Bromberg JS, Edye M. Laparoscopic donor nephrectomy: intraoperative safety, immediate morbidity, and delayed complications with 500 cases. Surg Endosc. 2007 Apr;21(4):521-6. doi: 10.1007/s00464-006-9021-y. Epub 2006 Dec 16.

  PMID: 17180288 BACKGROUND

• Jalali M, Rahmani S, Joyce AD, Cartledge JJ, Lewis MH, Ahmad N. Laparoscopic donor nephrectomy: an increasingly common cause for testicular pain and swelling. Ann R Coll Surg Engl. 2012 Sep;94(6):407-10. doi: 10.1308/003588412X13171221592177.

  PMID: 22943330 BACKGROUND

• Kim FJ, Pinto P, Su LM, Jarrett TW, Rattner LE, Montgomery R, Kavoussi LR. Ipsilateral orchialgia after laparoscopic donor nephrectomy. J Endourol. 2003 Aug;17(6):405-9. doi: 10.1089/089277903767923209.

  PMID: 12965068 BACKGROUND

MeSH Terms

Conditions

Testicular Hydrocele; Kidney Neoplasms

Condition Hierarchy (Ancestors)

Testicular Diseases; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Male Urogenital Diseases; Gonadal Disorders; Endocrine System Diseases; Urologic Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Kidney Diseases; Urologic Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 7, 2026
• First Posted: April 14, 2026
• Study Start: July 1, 1992
• Primary Completion: March 31, 2024
• Study Completion: March 31, 2025
• Last Updated: April 14, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share