Systematic Reviews
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World J Meta-Anal. Jun 18, 2025; 13(2): 100483
Published online Jun 18, 2025. doi: 10.13105/wjma.v13.i2.100483
Why the migration of peritoneal shunt catheter into the scrotum occurs more in children: A systematic literature review
Rajendra Kumar Ghritlaharey
Rajendra Kumar Ghritlaharey, Medical Superintendent and Professor of Pediatric Surgery, Mahaveer Institute of Medical Sciences and Research, Bhopal 462036, Madhya Pradesh, India
Author contributions: Ghritlaharey RK carried out the literature search, data extraction, writing, and revision of this manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rajendra Kumar Ghritlaharey, MS, MCh, Medical Superintendent and Professor of Pediatric Surgery, Mahaveer Institute of Medical Sciences and Research, Adjacent to I T Park, Village-Badwai, Bhopal 462036, Madhya Pradesh, India. drrajendrak1@rediffmail.com
Received: August 17, 2024
Revised: March 23, 2025
Accepted: April 16, 2025
Published online: June 18, 2025
Processing time: 302 Days and 12.6 Hours
Abstract
BACKGROUND

Ventriculoperitoneal shunt (VPS) catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus. Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion.

AIM

To review the demographics, clinical characteristics, and outcomes of the surgical procedures provided for the cases of migration of the distal VPS catheter into the scrotum.

METHODS

This is a systematic review of the published cases, and the literature search was performed from 1974 to June 30, 2024, to retrieve the relevant manuscripts. The cases were grouped into two. Group A included cases of migration of the distal VPS catheter into the scrotum, detected in children. Group B included the cases of migration of the distal VPS catheter into the scrotum, which was detected in adults and older people.

RESULTS

One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study, a systematic literature review. Group A included n = 112 cases, and group B included n = 8 cases only. Three-fourths of the cases involved the right scrotum. Bilateral involvement was rare. The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases. The majority were infants at the time of initial shunt insertion. Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum. In children, the interval from VPS insertion or shunt revision if any, to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases. The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure, and it was performed for two-thirds of group A cases.

CONCLUSION

Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion. It was most frequent in children, and the right side of the scrotum was most often involved.

Keywords: Infants; Children; Complication; Hydrocephalus; Migration; Scrotum

Core Tip: The present manuscript is a systematic review and was carried out to review the demographics, clinical features, and outcome of the surgical therapy executed for the migration of the distal ventriculoperitoneal shunt (VPS) catheter into the scrotum. This study included n = 120 cases (n = 112 children and n = 8 adults and older individuals) treated for the complication, mentioned above, and published from 1974 to June 30, 2024. Migration of the distal VPS catheter to the right scrotum was most frequent/common, both in children and adults, and older people. In children, the majority of cases (four-fifths) were diagnosed and treated for above mentioned VPS complication during the first 24 months of their life or earlier. Additionally, the complication was detected within the first 12 months after the initial VPS insertion, in four-fifths of the cases. Clinically, the cases presented with the chief complaint of scrotal swelling of varying duration. Two-thirds of the children underwent surgical repositioning of the migrated distal VPS catheter into the peritoneal cavity and herniotomy. The systematic literature review revealed two deaths among the adults/older patients and none among the children treated for migration of the distal VPS catheter into the scrotum.