Laparoscopic nephrectomy ups risk for scrotal surgery in male kidney donors

Undergoing laparoscopic nephrectomy may increase the risk for subsequent scrotal surgery in male living kidney donors, reports a study.

“A potential long-term complication of living kidney donation in male donors is scrotal swelling on the same side as the nephrectomy, and some undergo surgery to relieve discomfort from the fluid collection,” the authors said.

This population-based cohort study from 2002 to 2024 used linked administrative healthcare databases in Ontario, Canada, and identified 898 male living kidney donors who had a laparoscopic nephrectomy. These individuals were matched 1:10 with 8,980 male nondonors from the general population based on age, date of cohort entry, rural residence, income, prior vasectomy, and prior inguinal hernia repair.

The authors followed participants for a median of 9 years, up to 22 years. The primary outcome was hospitalization for surgery to address a unilateral scrotal fluid collection.

The median age of donor and matched nondonors was 45 years. The rate of scrotal surgery was higher among donors (7.8 percent vs 0.2 percent; 8.3 vs 0.2 events per 1,000 person-years; hazard ratio, 38.8, 95 percent confidence interval, 22.1–67.9; p<0.001).

The median time from donation to surgery was 5.2 years, with >90 percent of surgeries being hydrocelectomies and performed under general anaesthesia. Furthermore, the cumulative incidence stood at 13.8 percent in donors compared with 0.7 percent in nondonors over 20 years.

As a limitation, “[t]he precise causal mechanism remains unknown,” the authors said.