<prompt> Treatment of choice for congenital hydrocele?Sac eversionHerniotomyConservativeHernioraphy  <response>: Ans. B. Herniotomy. Ref. Bailey and Love 26thpg. 1382; 381. In congenital hydrocele, the processus vaginalis is patent and connects with the peritoneal cavity. The communication is usually too small to allow herniation of intra-abdominal contents. Pressure on the hydrocele does not always empty it but the hydrocele fluid may drain into the peritoneal cavity when the child is lying down; thus, the hydrocele is often intermittent. Ascites should be considered if the swellings are bilateral. Congenital hydroceles are treated by herniotomy if they do not resolve spontaneously. Established acquired hydroceles often have thick walls. Lords operation is suitable when the sac is reasonably thin- walled. There is minimal dissection and the risk of haematoma is reduced. Eversion of the sac with placement of the testis in a pouch prepared by dissection in the fascial planes of the scrotum is an alternative Jaboulays procedure. Herniotomy: In children who have lateral hernias with a persistent processus, it is sufficient only to remove and close the sac. This is called a herniotomy. In adult surgery, herniotomy alone has a high recurrence rate and some form of muscle strengthening is added herniorrhaphy. 