byAmerican College of Physicians

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A population-based cohort study evaluated the long-term scrotal surgery rates after laparoscopic nephrectomy in male living kidney donors compared with nondonors. The findings revealed that the cumulative incidence for scrotal surgery among donors was one in eight after 20 years, compared with one in 143 for nondonors. Even with this risk, most males who donate a kidney won't develop this complication, so it shouldn't discourage donation. Encouraging kidney donation remains vital.

The study is published inAnnals of Internal Medicine.

Some males who donate akidneythrough a laparoscopic technique end up with fluid building up around the testicle on the same side as the kidney that was removed. This is called a scrotal hydrocele. Over the years, this fluid accumulation can enlarge and cause discomfort requiring surgical drainage. Until now, we haven't had good information about how often this happens.

A team from the London Health Sciences Center Research Institute (LHSRI) and colleagues used linked administrative health care databases in Ontario, Canada to study almost 900 male patients who underwent a laparoscopicdonornephrectomy between 1 April 2002 and 31 March 2023.

These donors were matched in a 1:10 ratio with almost 9,000 male nondonors with similar baseline characteristics.

The researchers found that the rate of hospitalization forsurgeryto address a unilateral scrotal fluid collection was 8.3 per 1,000 person-years in donors compared to 0.2 per 1,000 person-years in nondonors.

Most surgeries were undergeneral anesthesiaand did not require ahospital stay. The hydrocelectomies occurred years after donation when the transplant surgeon was no longer involved in the donor's care. After this type of scrotal surgery, it typically takes a few weeks to fully heal and return to normal activities.

Overall, laparoscopic nephrectomy is associated with a higher long-term risk for scrotal surgery in male living kidney donors, underscoring the need for past and future male kidney donors to be informed about the risk and advised on symptoms to monitor after donation. Research is needed to understand if changing the donation surgery technique can lower the risk of it occurring.

More information: Risk for Scrotal Surgery After Laparoscopic Donor Nephrectomy: A Population-Based Cohort Study, Annals of Internal Medicine (2025). DOI: 10.7326/ANNALS-25-02257 Journal information: Annals of Internal Medicine

Provided by American College of Physicians