Syringomyelia is a condition in which the testicular sheath cavity contains a small amount of fluid so that the testicle has a certain range of sliding within the sheath cavity. If too much fluid accumulates in the sheath cavity, a sphingomyelomeningocele is formed. If the residual part of the peritoneal sphincter in the spermatic cord area that is not completely occluded, fluid can also accumulate and form spermatic cord syringomyelia. Causes of formation: During the mother’s pregnancy, the infant testis is located in the abdominal cavity, and early in embryonic development, the sphincter is formed, and the testis presses against the dorsal side of the sphincter and enters the scrotum through the inguinal canal. Under normal circumstances, the sphincter is first occluded from the internal inguinal ring before the fetus is born, and then, the sphincter near the testicular end also begins to be occluded until the sphincter in the spermatic cord is completely occluded, leaving only the testicular part with a lumen, forming the intrinsic testicular sphincter However, if there is an abnormality in the process of sphincter occlusion, the testicular sphincter cavity communicates with the abdominal cavity and the abdominal fluid flows into the sphincter, forming syringomyelia. Classification: According to the site of abnormal sphincter closure, it is broadly divided into 2 categories, namely spermatic cord syringomyelia and testicular syringomyelia. Syringomyelia of the spermatic cord: The sphincter of the spermatic cord is not closed, while the sphincter of the testis is occluded, and the abdominal fluid flows into the unclosed sphincter of the spermatic cord and ends above the testis. Compression of the spermatic vessels and vas deferens can affect the blood supply to the testes because the spermatic vessels provide blood supply to the testes, and therefore can affect testicular development. Testicular sphincter effusion: the whole sphincter is not closed, and the abdominal fluid can flow directly into the testicular sphincter cavity and encircle the testicular tissue. It compresses the testes and affects testicular development. Diagnosis: A cystic mass with clear borders appears on physical examination at the scrotum or groin, transillumination test (+), tension may decrease after partial extrusion, but there is no significant volume reduction, spermatic sphincter effusion is usually small in size, below the mass, the testis can be palpated, testicular sphincter effusion mass dangles at the bottom of the scrotum, if the mass has high tension, the testis generally cannot be palpated, if the mass does not have high tension, the testis can be palpated in the mass If the mass is not in high tension, the testicle can be found in the mass. Differential diagnosis: 1, inguinal hernia: the mass can be palpated in the scrotum or groin, sometimes the intestinal pattern is visible, intestinal sounds can be heard, the mass can be retracted in the recumbent position (unless it is embedded), there is a sensation of impact at the inner ring when coughing, and the transillumination test is negative. 2. Testicular tumor: solid mass in the scrotum, hard texture, heavy feeling in the affected testicle, weighing like a scale, negative transillumination test. 3.Epididymitis: the affected side of the scrotum is swollen and painful, but it can often involve the opposite side, and in serious cases, the whole scrotum and the perineum are diffusely red and swollen. 4.Syringomyelia: If the syringomyelia is caused by trauma or hemorrhagic disease, the fluid is bloody or all blood, and the transillumination test is negative. Individual testicular tumors can also be accompanied by syringomyelia, and their masses are relatively heavy with transillumination test (-), and if necessary, ultrasound examination is feasible. Treatment: At present, our department adopts a minimally invasive method to treat pediatric syringomyelia, i.e. laparoscopic high ligation of the sphincter, which has the advantages of less trauma, quicker recovery, shorter operation time and more precise efficacy compared with traditional surgery, and can use laparoscopy to observe the contralateral situation during the operation, and if the contralateral sphincter is not closed, it can be treated together during the operation.