The birth of a child is always happiness for young parents. But sometimes it can be overshadowed by illness. Especially if its causes and consequences are completely unclear. Not only a lot of questions, but also real panic among parents is caused by the appearance of swelling of the scrotum and the bluishness of its skin in a boy.
Hydrocele (hydroxycele) is a one- or two-way pathological process in which fluid accumulates in the scrotum.
Sometimes testicular hydrocele is accompanied by other diseases: inguinal hernia, lymphocele (accumulation of lymph in the scrotum as a result of compression or injury to the lymph vessels), testicular lymphostasis (lymph stagnation) and funiculocele (hydrosis of the spermatic cord).
Development mechanism
The testicles of the fetus are located in the abdominal cavity and descend into the scrotum approximately in the seventh month of development, while taking with them part of the thin film of connective tissue, the peritoneum, which lines the cavity in the child’s tummy from the inside. This creates a pocket. Normally it should close before birth or during the first months of life, but sometimes this does not happen. Further, the mechanism of fluid accumulation depends on the type of hydrocele, which can be isolated or communicating.
With communicating hydrops, peritoneal fluid enters the pocket along the processus vaginalis, connecting the abdominal cavity and the scrotum. In most cases, this process can close on its own by the age of one and a half years, but still the disease cannot be left to chance.
With an isolated hydrocele, fluid is produced by the tunica vaginalis of the testicle. Normally, it is needed so that the testicle moves freely inside the scrotum. At the same time, a balance is maintained between its production and absorption. If it is disrupted, fluid begins to accumulate and hydrocele occurs.
Causes of testicular hydrocele
Conventionally, the causes of hydrocele development can be divided into two large groups: congenital and acquired.
Congenital dropsy is considered a minor developmental defect and is in no way associated with gene mutation. It is characterized by a mechanism of development of a communicating type. Non-fusion of the processus vaginalis (embryonic disorder) occurs for many reasons:
- pathological course of pregnancy: threat of miscarriage, infectious and chronic diseases of the mother, intrauterine infection;
- receiving a birth injury;
- (undescended testicle into the scrotum);
- prematurity;
- hypospadias (an abnormal development of the penis, in which the urethra opens not on the head, but on the shaft of the penis).
Also, hydrocele can occur as a result of constant increased intra-abdominal pressure, which accompanies a number of pathological processes:
- abdominal wall defects;
- ascites (accumulation of fluid in the abdominal cavity);
- ventriculoperitoneal shunts (devices for draining excess fluid into the abdominal cavity);
- peritoneal dialysis (a procedure for artificial blood purification using the filtration properties of the peritoneum).
Secondary testicular hydrocele, or reactive hydrocele, which in most cases is characterized by a non-communicating mechanism of development, can occur in the following cases:
- injuries to the scrotum area;
- testicular torsion;
- various inflammatory diseases of the testicle and its appendages (orchitis, epididymitis, etc.);
- filariasis (damage to the lymph nodes caused by) and other diseases leading to damage to the lymphatic system;
- tumor of the testicle and its appendages;
- complication of infectious diseases (,), including children's (for example, mumps);
- complication after surgical operations - hernia repair, varicocelectomy (removal of dilated veins of the testicle and spermatic cord) - due to damage to the structure of the spermatic cord, in particular the lymphatic vessels, while the absorption of fluid produced by the vaginal membrane is impaired;
- heavy.
Classification of hydrocele
Hydrocele of the testicles has been classified in several directions.
Depending on whether the vaginal duct is closed or open, there are:
- communicating hydrocele, in which fluid flows freely from the abdominal cavity to the scrotum and back; often complicated, and this is an indication for surgery;
- non-communicating hydrocele (isolated), which looks like a cyst, while the processus vaginalis is blind; This option can only be treated surgically.
Depending on the fluid pressure in the scrotum:
- tense hydrocele: the fluid is under pressure (in most cases this is a non-communicating version of hydrocele, which requires urgent surgery);
- mild dropsy (most often this is the communicating type).
Depending on the course of the process:
- acute (usually a consequence of inflammatory processes, injury or tumor);
- chronic (recurrent).
Without the necessary treatment, an acute process can easily become chronic.
According to localization they distinguish:
- unilateral hydrocele;
- bilateral hydrocele.
Depending on the reasons:
- congenital hydrocele (primary, idiopathic) is observed in boys under 3 years of age;
- acquired (secondary, reactive) – diagnosed in boys after three years of age.
Symptoms of testicular hydrocele
Most often, parents detect dropsy during hygiene measures. A surgeon can also detect the disease during a routine examination of the baby. This condition most often does not bother the child himself; there is no pain or discomfort.
The most common symptoms of hydrocele include enlargement of the scrotum on one or both sides in size and bluishness of its skin. Swelling in the groin area may indicate a hernia or other associated pathological conditions.
In case of injury, soreness of the scrotum appears, and with secondary infection of the hydrocele, more serious symptoms occur:
- crying and restlessness of the baby when touching the scrotum;
- fever and symptoms of general malaise;
- chills;
- redness of the skin at the site of the lesion;
- , vomit;
- difficulty urinating, acute urinary retention is possible;
- unpleasant bursting sensations in the groin area, discomfort when walking, which older children complain about.
A communicating hydrocele can change in size and tension throughout the day, while isolated hydrocele increases gradually.
It is especially dangerous when the disease occurs in adolescence. Boys are often embarrassed to tell their parents about their problems and allow the disease to develop into complications.
Diagnostics
The doctor will notice the problem when examining the child's genitals. Diagnosis of hydrocele is not particularly difficult and consists of several successive steps:
- collection of characteristic complaints of parents or children;
- examination of the child by a surgeon or urologist.
Such an examination is carried out in a standing and lying position, as this will help to understand what type of hydrocele the testicle has, communicating or isolated. Usually, in the supine position, the communicating hydrocele decreases in size. This type of dropsy may also be indicated by its increase during coughing, since this increases intra-abdominal pressure.
- Palpation (palpation) of the scrotum, which reveals an elastic pear-shaped seal, with its upper end facing the inguinal canal;
- diaphanoscopy (transillumination): looking through the scrotum with a flashlight.
Liquid always transmits light well, while a tumor or omentum, as well as part of the intestine with an inguinal-scrotal hernia, will retain it.
- Ultrasound of the scrotum and inguinal canals is the most accurate method in which you can see the type of hydrocele, the condition of the testicle, the presence and amount of fluid, and also exclude more serious pathologies, for example, inflammation, torsion of the testicle and its appendages;
- Ultrasound scanning of the scrotal vessels is an additional examination method that will help to make a final diagnosis;
- blood tests will show the general condition of the body and facilitate differential diagnosis with other pathologies of the scrotum and testicle, as well as their complications.
Treatment of hydrocele
The method of treating hydrocele directly depends on the type and causes of the pathology.
Physiological dropsy is quite simple to observe. This is a wait-and-see approach, since in babies under one year of age, hydrocele may go away on its own. In this case, the only thing that is required from parents is the prevention of colds and digestive disorders, since sneezing, coughing and vomiting cause a sharp jump in intra-abdominal pressure. And this, in turn, contributes to the flow of fluid into the scrotum.
In case of acquired hydrocele, the primary disease that caused the pathology should be treated first.
Thus, for post-traumatic hydrocele of the testicles (Dolaren, Fanigan, Ibuprofen, Movalis, Paracetamol, Diclofenac, Nurofen, etc.) are indicated to relieve swelling and pain, and for infectious hydrocele, antibiotics are also added to non-steroidal anti-inflammatory drugs (Augmentin, Flemoxin, Tsiprinol, Abaktal, etc.).
Surgical treatment
For isolated dropsy, a Winckelmann, Lord or Bergmann operation is performed (if the child is over 12 years old), as well as a puncture. An incision is made on the scrotum at the site of the projection of the dropsy, the testicle is brought out through the wound, the fluid is sucked out and the vaginal membrane is dissected.
During the Winkelmann operation, this membrane is turned inside out and sutured. Then all the produced fluid will be absorbed by the surrounding tissues. Next, everything is stitched together layer by layer, leaving a small rubber drainage in the wound for blood outflow.
During Bergmann's operation, which is performed for large hydroceles and thick membranes, the processus vaginalis is simply excised at its very base, and the remains are stitched with special sutures. After which the testicle is immersed back into the scrotum, and everything is sutured layer by layer, leaving a small drainage in the wound.
Unlike the two previous operations, Lord's operation is the least traumatic, since there is no need to remove the testicle into the wound. Consequently, the tissues and blood vessels surrounding the testicle are not injured. The vaginal membrane itself is simply crimped and sutured.
Communicating dropsy is treated with the Ross operation, in which the processus vaginalis is carefully ligated in the area of the internal inguinal ring and cut off. An opening is then created in the tunica vaginalis to drain fluid from the scrotum.
Surgery for post-traumatic dropsy is indicated after 3-6 months from the moment of injury, and until this point only observation is necessary. At this time, reduction (decrease in size) of the hydrocele sometimes occurs.
Indications for surgery before the age of two:
- the presence of an inguinal hernia and the risk of strangulation;
- constant discomfort in the groin area;
- rapid and intense increase in size of the scrotum, especially with a tense hydrocele;
- infection of hydrocele of the testicle.
Tense dropsy can only be treated surgically. And the sooner the better. In this condition, a puncture is necessary, as a result of which all the fluid will be removed. But it does not guarantee that the effusion will not appear again.
Features of preparation and course of the operation
Surgical treatment of congenital hydrocele is carried out at 1.5-2 years. It is only necessary if the dropsy does not go away for a long time. Moreover, the larger its size, the faster the operation needs to be done.
The child must be healthy; after suffering from a cold and other diseases, some time must pass (but not less than a month) for the body to become stronger. Before the operation, you need to take a general blood and urine test, and six hours before surgery, the little patient should not eat or drink anything.
Technically the operation is not difficult. It is performed under general anesthesia (although intervention under local anesthesia is easier for the doctor to control), and additional injection of painkillers into the vein is possible. During the operation, breathing and heartbeat must be monitored. It lasts about forty minutes and can be performed on an outpatient basis. Immediately after the operation, an ice pack is placed on the wound area for two hours, after which the doctor must apply a suspending bandage or suspensor.
In a few hours, the child can be sent home with his mother. In the evening, the baby can drink, and a little later, eat.
Thanks to general anesthesia, the child will not have psycho-emotional stress at the sight of instruments, strangers in white coats and strange smells. There will also be no unpleasant memories of the procedure.
Transient symptoms of pain and discomfort are best treated with conventional non-steroidal anti-inflammatory drugs, such as Paracetamol or Ibuprofen.
If the wound has sutures made of non-absorbable material, then after a week you need to go to the doctor and have them removed.
The child should have his next doctor's examination in a month.
After surgery you cannot:
- engage in active games, the child only needs peace;
- touch the wound so as not to cause bleeding or infection;
- wet the wound before removing the stitches; but the child can wash himself carefully.
To avoid postoperative complications, the mother must strictly follow all the surgeon’s recommendations.
Possible complications after surgery:
- complications after anesthesia are quite rare;
- infection: also an infrequent complication; to prevent it, it is enough to prescribe a course of antibiotics lasting 7-14 days;
- bleeding: a rare phenomenon that can be eliminated by applying pressure to the wound area, and only as a last resort should one resort to surgery;
- recurrence of dropsy can occur only if the testicle is located higher than before the operation;
- if during the operation the blood vessels supplying blood to the testicle or its seminal ducts are damaged, then there is a possibility of infertility, especially if the second testicle is also involved in some pathological process;
- testicular atrophy due to disruption of its blood supply;
- pain and discomfort in the groin area;
- change in the appearance of the scrotum, its deformation;
- fixation of the testicle with scars when it is strongly raised upward.
Puncture method of treatment
The simplest treatment method. It involves puncturing the dropsy and pumping out fluid from it. The effect of treatment is very short-lived and always leads to relapse of the disease.
What is testicular hydrocele?
Hydrocele, also known as hydrocele or hydrocele, is an accumulation of fluid in the membranes of the testicle, which leads to enlargement of the scrotum, and sometimes swelling in the groin area.
There is isolated hydrocele of the testicular membranes, when the fluid surrounds the testicle and cannot flow into other cavities, and communicating hydrocele.
A communicating hydrocele differs in that hydrocele can flow into the abdominal cavity and back through a special duct - the vaginal process of the peritoneum. Hydrocele of the testicle is often combined with an inguinal hernia.
Lymphocele is a concept close to testicular hydrocele, meaning the accumulation of lymph in the membranes of the testicle, which occurs when the lymphatic vessels of the testicle are damaged or compressed. Typically, lymphocele is accompanied by stagnation of lymph in the testicle and its membranes - lymphostasis
Why does hydrocele need to be treated?
The testicle is extremely sensitive to temperature changes and can only function normally within a narrow temperature range. An increase in testicular temperature even by tenths of a degree disrupts the development and function of the testicle.
Hydrocele is an additional layer around the testicle that prevents heat transfer and leads to overheating of the testicle. As a result, spermatogenesis and hormonal function of the testicle are disrupted, which is the cause of infertility.
Causes of non-fusion of the peritoneal process.
Many theories explain non-fusion of the processus vaginalis of the peritoneum. Thus, in the open vaginal process of the peritoneum, smooth muscle fibers were found, which are not found in the normal peritoneum. Smooth muscles can prevent fusion of the peritoneal process.
According to our data, there is a higher incidence of reported hydrocele in children born after a pathological pregnancy with threatened miscarriage, as well as in premature children.
Another reason lies in the increase in intra-abdominal pressure, which is observed during resuscitation measures, with frequent restlessness of the child or during physical exercise. Causes of non-fusion of the peritoneal process.
Many theories explain non-fusion of the processus vaginalis of the peritoneum. Thus, in the open vaginal process of the peritoneum, smooth muscle fibers were found, which are not found in the normal peritoneum. Smooth muscles can prevent fusion of the peritoneal process.
According to our data, there is a higher incidence of reported hydrocele in children born after a pathological pregnancy with threatened miscarriage, as well as in premature children.
Another reason lies in the increase in intra-abdominal pressure, which is observed during resuscitation measures, with frequent restlessness of the child or during physical exercise.
What does communicating hydrocele of the testicular membranes and an inguinal hernia have in common?
An inguinal or inguinal-scrotal hernia occurs in children with a wide, unclosed processus vaginalis of the peritoneum. Not only fluid from the abdominal cavity penetrates into the open vaginal process of the peritoneum, but also movable organs of the abdominal cavity can emerge (loop of intestine, strand of omentum, appendages in girls, etc.), which characterizes an “oblique” inguinal or inguinoscrotal hernia.
In adults, inguinal hernias differ from those in children. They are associated with defects in the muscles and tendons of the anterior abdominal wall that occur during exercise. In childhood, such hernias are extremely rare. Therefore, operations for inguinal hernias in children and adults are performed using various methods.
How often does communicating hydrocele disappear without surgery?
Spontaneous fusion of the peritoneal process and self-healing of communicating hydrocele of the testicle is often observed in the first months of life and very rarely later than 1 year (no more than 5% of observations). Most children with communicating hydrocele of the testicle require surgical treatment, which is recommended at the age of 1.5 - 2 years. Failure to follow these recommendations leads to testicular underdevelopment and reduced chances of having children.
How common is testicular hydrocele and how often is surgery required?
Hydrocele of the testicular membranes in newborns and boys in the first year of life occurs in 8-10% of cases. In 80% of cases it is isolated and goes away on its own. In 20% of children, surgery is performed after one year.
Communicating hydrocele of the testicle in children after 1 year 0.5-2.0%. In 95% of cases, surgical treatment is indicated.
Lymphocele and testicular lymphostasis in adolescents after operations for varicocele account for from 1% to 25% of all surgical interventions, depending on the type of operation and surgical technique (on average about 10-12%). In 80% it is amenable to conservative treatment. In the remaining 20%, surgical treatment is indicated.
Hydrocele and lymphocele after surgery for inguinal hernia in adolescents - statistics are the same as in adults 3-10%. Surgical treatment is often performed.
How to diagnose hydrocele?
The disease usually occurs with obvious external manifestations - swelling (increase in volume) of the scrotum on one or both sides. Scrotal enlargement may decrease or disappear at night when the child is in a horizontal position, and reappear when awake. This is evidence in favor of communicating hydrocele of the testicular membranes. Enlargement of the scrotum is sometimes also observed with tension or “inflating” of the abdomen.
Subjective sensations are insignificant. Complaints are rare. In case of acute, infected or tense dropsy, pain may be observed.
To establish the correct diagnosis, ultrasound is used - ultrasound examination of the inguinal canals and scrotal organs and duplex examination of testicular vessels.
Ultrasound often makes it possible to detect a problem from the other side - for example, an inguinal hernia or spermatic cord cyst that is invisible during examination.
Sometimes enlargement of the scrotum and groin area appears and disappears, and may be absent upon examination by a doctor. Then a photograph taken when a swelling appears in the scrotum or groin area, taken by the parents, helps resolve the issue of diagnosis.
Diseases and circumstances that are often accompanied by the occurrence of hydrocele
Cryptorchidism (undescended testicle)
Hypospadias
False hermaphroditism
Epispadias and exstrophy
Ventriculo-peritoneal shunt
Prematurity
Low birth weight
Liver diseases with ascites
Defects of the anterior abdominal wall
Peritoneal dialysis
Burdened heredity
Cystic fibrosis
Inflammatory diseases of the scrotum leading to the development of reactive hydrocele
Testicular torsion
Injury
Infection
Previous operations affecting the lymphatic system of the testicle
Treatment of hydrocele (hydrocele) and lymphocele without surgery. Duration of observation.
Hydrocele in children under 1 year of age requires observation by a pediatric urologist-andrologist. If fluid accumulates and tension appears in the membranes of the testicle, punctures are performed to remove hydrocele. Sometimes repeated punctures are required.
Communicating hydrops with a narrow peritoneal process is usually observed up to 2 years.
Observation is also required for traumatic dropsy that occurs as a result of a bruise without compromising the integrity of the testicle. As a rule, 3 months are enough to assess the dynamics of the process and, if there is no improvement, prescribe surgical treatment. The same applies to hydrocele formed after inflammation.
The most difficult is the management of patients with lymphocele that forms after surgical treatment of an inguinal hernia and varicocele. In this case, prematurely performed surgery has little chance of success. For 6-12 months, it is necessary to monitor the condition of the testicle according to ultrasound and duplex examination of the scrotal organs in order to assess the dynamics of the process and the effectiveness of the therapy.
When is surgery performed for hydrocele?
Operations for communicating hydrocele of the testicle are most often performed in children aged 2 years.
From 1 to 2 years, operations for communicating hydrops are performed if:
combined dropsy and inguinal hernia
when the volume of the scrotum clearly changes with changes in body position
dropsy increases, causing discomfort
infection joins
Surgeries for post-traumatic dropsy – 3-6 months after injury.
Lymphocele that occurs after surgery for an inguinal hernia or varicocele is operated on 6 to 18 months after the appearance of fluid in the membranes of the testicle.
Which anesthesia option is best for a child?
The best option for pain relief during operations for hydrocele in childhood is modern combined anesthesia using local anesthesia with long-acting drugs (marcaine, naropin) and mask anesthesia (sevoflurane).
Surgery for hydrocele (hydrocele). Surgical options.
The type of operation depends on the age of the patient and the characteristics of the dropsy.
Surgery for communicating hydrocele of the testicle. Operation Ross.
For communicating dropsy, as a rule, the Ross technique is used - isolation from the elements of the spermatic cord, excision and ligation of the internal inguinal ring of the peritoneal process, as well as the formation of a “window” in the membranes of the testicle. The operation is performed through a small incision in the groin area.
The operation is delicate, requiring good technique - careful and careful preparation while preserving all the anatomical formations of the spermatic cord - the vas deferens and testicular vessels, as well as the inguinal nerve.
Laparoscopic operations are sometimes used for testicular hydrocele, but the morbidity, risk of relapses and complications when using them are higher, and the duration of anesthesia is longer, so they are not widely used.
Operations for isolated hydrocele of the testicular membranes and lymphocele in children and adolescents.
Isolated hydrocele and lymphocele are indications for Bergman's operation - excision of the inner membranes of the testicle from the scrotal approach. In cases of large hydroceles and lymphoceles, drainage is often left in the wound and pressure bandages are applied.
Winkelmann's operation is a dissection of the testicular membranes in front and suturing the resulting edges of the membranes behind the epididymis. Currently used rarely due to changes in the appearance of the scrotum and testicular contours.
Among the complications, the most common is recurrence of dropsy (5-20%), which in case of lymphocele can reach 70%. A particularly high percentage of relapses is observed when operations are not performed on time.
Postoperative period
Surgeries for dropsy are usually well tolerated by children and do not significantly interfere with their movements. However, with sudden movements or constipation as a result of increased intra-abdominal pressure or direct impacts, the formation of hematomas in the scrotum and groin area is possible. Therefore, children should limit their activity until the postoperative wound heals and follow a diet.
On the first day after surgery, non-narcotic painkillers (analgin, paracetamol, ibuprofen, Panadol and others) are usually prescribed. Laxatives are used for 4-5 days after surgery.
For 2 weeks after surgery, do not wear underwear that compresses the scrotum to avoid pushing the testicle up toward the inguinal canal, due to possible fixation of the testicle above the scrotum.
School-age children are exempt from physical education for 1 month.
Forecast for the future?
If the timing of surgical treatment is observed and the operations are technically flawless, the prognosis for health and the ability to have children is favorable in the vast majority of cases.
Hydrocele in a child (in other words, hydrocele) is a pathological process that involves the appearance of fluid in it. Late treatment or lack thereof leads to significant swelling of the groin.
Often the disease has a one-sided manifestation and is therefore difficult to detect.
To prevent the pathology from developing and spreading to other organs, it is necessary to ensure that the sick baby is monitored by the attending physician, as well as preventive examinations.
The testicle is highly sensitive to any changes in temperature conditions, so normal functioning is possible only within a narrow range.
If the temperature rises slightly, even by 10ths of a degree, development and functional characteristics are disrupted.
Dropsy is represented by an additional shell, a layer around it, so there is a significant obstacle to the process of heat transfer and, as a result, overheating occurs, leading to a disruption of spermatogenesis and the hormonal options of the body.
Untreated hydrocele can cause infertility.
Statistics on the incidence of hydrocele
The disease is common and occurs in about 9% of newborns in the first months of life.
In newborn boys, the disease is diagnosed in the maternity hospital during the initial examination, and in older children, the manifestation occurs later.
In 80% of cases, the disease is isolated and can resolve itself.
In 20% of situations after one year of age, surgery for hydrocele is performed. If a boy is diagnosed with an illness when he reaches the age of 1 year, surgical intervention is indicated in 95% of situations.
Types of disease
Communicating dropsy
Communicating hydrocele in children is a common condition. In the absence of fusion of the membranes or their obliteration, we can talk about the preservation of the cavity of the vaginal process, which is open into the peritoneal cavity.
If only fluid is retained, there may be a communicable disease. Hydrocele may appear on the left or right testicle, as well as on both sides.
Often, the omentum or intestinal loop may be adjacent to the liquid medium; in this situation, an inguinal hernia is formed, requiring urgent surgery.
Isolated dropsy
Typically, hydrocele of this type occurs in premature babies; a common cause lies in insufficiently developed lymphatic vessels or in trauma received during childbirth.
The formation of non-communicating hydrocele of the testicle occurs when the fluid is not completely absorbed; at the same time, other membranes may be underdeveloped.
Usually the fluid returns to normal on its own, and the process does not require medical intervention.
Acquired dropsy
If there is an acquired disease, it occurs during injuries to the scrotum, due to inflammatory processes in the body and as part of the delayed consequences after hernia operations.
Such a disease should be treated by a medical professional.
Causes of testicular hydrocele in boys
If we are talking about a congenital type of disease, then its formation is caused by the presence of a reason such as a violation of the embryological plan.
After the descent of the testicle into the scrotum, which occurs at the 28th week of gestation, obliteration of the proximal region of the peritoneal process is observed, and a membrane is formed.
If by the 40th week - birth - this process does not heal, a fluid-filled connection is observed between the scrotum and the abdominal cavity. By 1.5 years, it begins to grow on its own.
If the process does not heal, this usually happens due to pathologies during pregnancy in the form of prematurity, cryptorchidism and birth trauma, these are the main causes of testicular hydrocele.
If testicular hydrocele is detected in a child over three years old, it is usually secondary. Reactive hydrocele in children is associated with filtration problems.
These disorders can be provoked by testicular torsion, inflammation - orchitis, epididymitis, tumor. Acute dropsy can act as a complication due to the cause of ARVI and influenza, mumps and other infections.
Manifestation and symptoms of the disease
Typically, symptoms of hydrocele disappear by two years and do not require additional treatment measures. If this does not happen, it will be necessary for a specialist to intervene in the matter, who can accurately diagnose and prescribe treatment.
The progression of symptoms occurs unnoticed, if you do not take into account the enlargement of the testicle. Liquid accumulates in it, which leads to such changes. To prevent the disease and its timely treatment, it is recommended to study the main signs.
- The scrotum begins to enlarge on one or both sides: it becomes noticeable only when the baby tenses his tummy.
- In the process of carrying out an independent palpation method, the mother may also detect a pear-shaped formation.
If such signs occur, you need to contact a specialist to conduct additional research and get tested.
It is also important to pay attention to secondary additional symptoms, which also play an important role.
- manifestation of pain in the groin area;
- the appearance of redness in the skin of the scrotum;
- sensations of nausea and a pronounced gag reflex;
- the occurrence of general tremors in the body;
- noticeable increase in temperature, malaise.
Often mothers who have discovered such signs in their baby try to independently treat the child. However, there is no need for independent measures, since only a doctor can give advice and recommendations for the treatment of hydrocele.
Diagnosis of dropsy in boys
Dropsy in children under one year of age is usually diagnosed without difficulty.
If parents discover small swellings in the scrotum area, parents should immediately contact a surgeon or urologist, who will perform palpation and make a diagnosis.
The examination process takes place when the child is in a lying or standing position.
This technique is used to determine the form of the disease and its type. If the size decreases when lying down, a communicating type of testicular hydrocele is usually diagnosed, which may also be indicated by an excess of the scrotum when coughing.
- Diaphanoscopy of the scrotum is one of the main diagnostic methods, involving the examination of tissues within the framework of transmitted light. As part of this study, the doctor can detect in the scrotum not only a fluid medium, but also an omentum, an element of the intestine that helps to delay the passage of the light flux.
- Ultrasound examination in the area of the inguinal canals and the scrotum itself allows you to confirm the diagnosis and exclude pathologies of a more serious nature - oncology, inflammatory processes. In addition to the main research technique, ultrasound scanning is performed.
- Differential diagnosis is one of the most common methods used to determine whether the scrotum is strangulated by a hernia, testicular torsion or a cyst.
The disease is diagnosed by all these methods, since their combined use allows us to understand the overall picture and prescribe appropriate treatment.
The doctor also relies on the symptoms of the disease and the main complaints of the parents.
Therapeutic measures
Treatment, or rather, the measures to carry it out, are determined based on the age criteria of the baby.
Congenital hydrocele of the testicle is not treated until the child reaches 2 years of age, since, as already noted, it can disappear on its own.
But if the size significantly exceeds the norms, it is worth sounding the alarm bells and using removal - a puncture during which fluid is removed from the scrotum using a syringe.
Surgery
The operation assumes the presence of an indication in the form of a significant change in the size of the hydrocele of the testicle, because this factor can contribute to the formation of a hernia and cause strangulation of the intestine.
The operation will remove the disease without leaving a trace; several types are currently being carried out.
Winkelmann operation
This operation is performed using general anesthesia. In this case, a small cut of 5 cm in the skin is made on the scrotum, on its swollen area, and the testicle is removed to the wound.
Then all the liquid is removed from the shell. When carrying out the technique, the entire testicular area is also subject to examination. To speed up recovery, apply an ice pack to the wound for several hours.
Bergman's operation
This operation has several repetitions with the previous technique, especially at first. The size of the incision made in the scrotum area is 6 cm.
After this, the membranes are cut layer by layer, and the testicle is brought out onto the wound, the doctor pumps out the resulting fluid. Sutures are placed on the cutout fragments, then the testicle is “inserted” back.
Operation Lord
This operation is accompanied by cutting the pouch and subsequent corrugation of its shell. This treatment of testicular hydrocele is one of the most effective and safest methods.
The use of folk remedies for dropsy
Treatment of the disease can also be carried out using traditional methods. If it is too early to operate, and the main symptoms need to be eliminated, the following remedies are used.
- Chamomile has a powerful anti-inflammatory effect; use as a decoction prevents infection by bacteria and infectious processes.
- Stinging nettle is one of the most effective remedies that can be used to treat hydrocele. The decoction is taken orally after meals.
- An infusion of birch buds is used in the spring. It is necessary to grind the “raw materials” in a meat grinder and boil.
As you can see, hydrocele of the testicular membranes is a serious disease that, if left untreated, can cause serious consequences.
To preserve children's health, it is important to promptly identify signs of illness and begin treatment.
We hope that the article helped you understand why hydrocele occurs in the testicular membranes in a child. If so, give it 5 stars!
Hydrocele of the testicle or hydrocele - a disease in which there is an accumulation of serous fluid between the parietal and visceral plates of the tunica vaginalis of the testicle. Hydrocele of the testicle is most common among men aged 20-30 years, but the disease can also be congenital.
In newborns, there are communicating dropsy of the testicular membranes, which can go away on their own. In adult men, testicular hydrocele can be a complication after surgery for varicocele, etc.
The disease can occur in acute or chronic form. The acute form occurs as a result of inflammation of the testicle, testicular tumor or injury to the scrotum. The acute form without appropriate treatment can become chronic. Various chronic diseases of the scrotal organs also lead to chronic hydrocele.
Causes of hydrocele
The main function of the tunica vaginalis of the testicle is to produce fluid that allows the testicle to move freely within the scrotum. There is a certain balance between the production of fluid and its reabsorption. If the absorption of fluid by the vaginal membrane is disrupted, it accumulates and, as a result, dropsy begins. Causes of hydrocele:
- congenital condition;
- inflammatory processes of the testicle and its epididymis (orchiepididymitis);
- lesions of the inguinal and pelvic lymph nodes (filariasis);
- scrotal injuries;
- severe heart failure.
Classification of hydrocele
- Congenital:
- Communicating - the cavity communicates with the abdominal cavity.
- Non-communicating - does not communicate with the abdominal cavity.
- Purchased:
- Primary (idiopathic) – develops for no apparent reason.
- Secondary (develops as a result of an inflammatory process, injury).
Congenital hydrocele of the testicle
In most cases, hydrocele has a congenital form. The appearance of this pathology is due to a number of reasons:
- disorders of embryological development;
- threat of miscarriage;
- fetal prematurity;
- injury during childbirth;
- hypospadias;
- increased intra-abdominal pressure.
As practice shows, newborn boys who have suffered from congenital dropsy may experience a relapse closer to 3 years of age. The appearance of secondary hydrocele is provoked by the following factors:
- testicular torsion;
- inflammatory diseases (for example, epididymitis or orchitis, etc.);
- transmission of mumps or flu;
- surgical intervention associated with excision of a hernia.
Acquired hydrocele of the testicle
In the first year of life, boys may develop an acquired form of testicular hydrocele only if this organ is injured or as a result of exposure to elevated temperature.
For example, if at elevated air temperatures a child is constantly wearing a diaper, this can provoke the appearance of an inflammatory process in the scrotum or testicles and, as a result, the development of hydrocele.
Most often, the acquired form of dropsy occurs in sexually mature males. The development of such a disease may be due to the following reasons:
Symptoms of hydrocele
The first symptom of a clear manifestation of testicular hydrocele is an increase in the size of one or two testicles. They can be felt with great difficulty, the skin in their area becomes smooth, but still gathers into folds quite freely. A dull pain occurs in the groin area.
If you lightly press on the testicle, on the contrary, from the point of pressure the shell seems to protrude. In the future, an increase in body temperature is possible, and it becomes difficult and uncomfortable for the patient to wear underwear, as too much fluid accumulates.
It is worth noting that the volume of liquid can vary from a small amount to several liters. This, in turn, seriously impedes the man’s movement, causes unpleasant pain during intimacy with his partner, and discomfort when urinating.
That is why, as soon as a representative of the stronger sex feels that his testicle is swollen, he should immediately contact a specialist - a urologist, otherwise the disease may become chronic.
Descriptions of symptoms of hydrocele
Diagnosis of hydrocele
As a rule, diagnosing dropsy does not cause any difficulties for a professional doctor. To begin with, the doctor simply examines and feels the patient's genitals. More information can be obtained by resorting to ultrasound examination, since in this way the condition of the testicle itself and the amount of aqueous fluid in its shell are assessed.
Also, in order to correctly diagnose hydrocele, they resort to transillumination of the scrotum - diaphanoscopy. If the hydrocele is in an advanced state, additional, even more complex studies are used.
Treatment of hydrocele
Treatment of hydrocele of the testicle is carried out only by surgery. It is necessary not only to remove the accumulated fluid between the layers of the vaginal membrane, but also to eliminate the cause of the disease. There are several types of operations during which the vaginal lining is eliminated.
The operation is performed under local or general anesthesia and lasts no more than 30 minutes. After two hours the patient is allowed to go home. Relapses after such operations are quite rare, but swelling of the scrotum and inflammation of the testicle are possible, which is associated with their mechanical irritation during surgery.
In most patients, these complications resolve on their own within two weeks; if this does not happen, then antibacterial and anti-inflammatory drugs are prescribed.
Surgery for the treatment of hydrocele
The essence of any operation that permanently eliminates hydrocele is the elimination of the tunica vaginalis of the testicle by dissection and stitching in an inverted state (Winkelmann operation), excision and removal (Bergmann operation) or dissection followed by folding (plication) using special sutures (Lord operation). The experience of a huge number of such operations has shown that the testicle functions normally and does not cause any trouble to a person if its vaginal membrane is removed.
This operation is performed on an outpatient basis, most often under local or intravenous anesthesia and takes 25 to 30 minutes. 2 - 3 hours after the operation or as soon as the anesthesia wears off, the patient can go home. After the operation, it is necessary to visit the doctor 2-3 times for follow-up examinations, changing the bandage and removing sutures. There are practically no relapses of hydrocele of the testicular membranes after the above operations.
The most common complications of these operations are inflammation of the testicle, associated with its mechanical irritation during surgery, and swelling of the scrotum. These complications, to one degree or another, occur with a frequency of 20 to 50% of cases, but they resolve in almost everyone on their own and most often without any treatment within 2 weeks after surgery. Some patients, in the presence of these complications, have to be prescribed antibiotics and anti-inflammatory drugs.
Another common complication of hydrocele surgery is bleeding or scrotal hematoma, which occurs in up to 5% of cases. The development of a hematoma is due to the fact that during the operation some, often small, blood vessel was not noticed, prolonged bleeding from which causes the formation of a hematoma.
Small hematomas do not require any additional treatment and resolve on their own. Large scrotal hematomas require opening and drainage. To prevent the formation of hematomas, if there is no confidence in stopping the bleeding thoroughly, drains are installed after the operation. The higher the qualifications and more experience of the operating surgeons, the lower the frequency of possible complications of the operation.
Sclerotherapy for hydrocele
This treatment method involves the evacuation of hydrocele from the testicular membranes and the introduction of sclerosing substances into them, for example, alcohol, betadine and others. The principle of the method is that these substances cause aseptic (that is, non-infectious) inflammation of the testicular membranes and their further fusion. As a result, the cavity in which liquid can accumulate completely disappears. Researchers using this method report a low relapse rate after this treatment (about 1%).
Endoscopic treatment of hydrocele
Currently, endoscopic treatment of hydrocele has become popular. The attractive side of this surgical technique is:
Complications of hydrocele
If you do not resort to timely surgery, dropsy can lead to:
- compression of the testicles;
- disruption of spermatogenesis, which will cause the formation of male infertility;
- decreased potency;
- premature ejaculation during sex;
- necrosis of testicular tissue;
- such an aesthetic defect as a pronounced enlargement of the scrotum visible through a layer of clothing.
Prevention of hydrocele
To prevent hydrocele, you should avoid injuries to the scrotum, and be sure to consult a doctor for any injuries to the testicles. Also, the prevention of testicular hydrocele is the timely treatment of genital infections (for example, chlamydia) and inflammatory diseases. Remember that using a puncture will not help cure hydrocele, since in all cases of its use, testicular hydrocele recurs.
Hydrocele in boys
Hydrocele in boys is an accumulation of serous fluid produced by the tunica vaginalis of the testicle between its layers. Hydrocele in boys is accompanied by an increase in the size of the scrotum on one or both sides, and sometimes by difficulty urinating.
Causes of hydrocele in boys
Congenital hydrocele in boys is caused by embryological disorders. At approximately 28 weeks of intrauterine development, the testicle descends through the inguinal canal into the scrotum, and with it the processus vaginalis of the peritoneum moves into the scrotum. Subsequently, the proximal part of the peritoneal process is obliterated, and the tunica vaginalis of the testicle is formed from the distal part.
If at the time of birth the processus vaginalis of the peritoneum does not heal, this leads to the presence of a residual communication between the scrotum and the abdominal cavity, the entry and accumulation of peritoneal fluid in the scrotal cavity. In addition, the inner lining of the peritoneal process is itself capable of producing fluid, leading to the development of hydrocele in boys. The peritoneal process remains open in 80% of newborn boys, but in most cases it heals on its own by 1.5 years.
Non-closure of the processus vaginalis and the formation of hydrocele in boys under 3 years of age is facilitated by the pathological course of pregnancy in the mother (threat of miscarriage), birth trauma, prematurity, cryptorchidism, hypospadias, as well as conditions accompanied by a constant increase in intra-abdominal pressure - abdominal wall defects, ascites, ventriculoperitoneal shunts, peritoneal dialysis, etc.
In boys over 3 years of age, testicular hydrocele is usually secondary. Reactive hydrocele is associated with a violation of the processes of filtration and reabsorption of fluid produced by the tunica vaginalis of the testicle. Such disorders can be caused by testicular torsion, trauma to the scrotum area, inflammatory diseases (orchitis, epididymitis, etc.), tumors of the testicle and its epididymis.
In rare cases, acute testicular hydrocele in boys can be a complication of ARVI, influenza, mumps and other childhood infections. In addition, acquired testicular hydrocele in boys can develop as a postoperative complication after hernia repair or surgery for varicocele (varicocelectomy).
Symptoms of hydrocele in boys
Typically, signs of testicular hydrocele in boys are discovered by parents during hygiene procedures. Sometimes a pediatric surgeon identifies a hydrocele during a routine examination of the child. With hydrocele in boys, the scrotum increases in size on one or both sides. In the case of a communicating hydrocele, the enlargement of the scrotum is transient; in isolated cases, the scrotum enlarges gradually. The size of the scrotum in boys with hydrocele can reach the size of a goose egg, and in advanced cases, a child’s head.
Communicating hydrocele in boys can have different sizes and tensions during the day: the swelling of the scrotum reaches its greatest size during the day, when the child moves; at night, in a lying position, the tumor may disappear due to the emptying of the contents of the hydrocele into the abdominal cavity. Hydrocele in boys, as a rule, is painless and without signs of inflammation. With secondary infection of the hydrocele, pain, redness of the scrotum, chills, fever, and vomiting may occur.
With a large volume of accumulated fluid, children may have difficulty urinating and develop acute urinary retention. Older children report unpleasant bursting sensations, heaviness in the groin area and discomfort when walking. In boys who have a wide open vaginal process of the peritoneum, along with hydrocele, oblique inguinal or inguinal-scrotal hernias can develop.
Treatment of hydrocele in boys
In children under 1 year of age with congenital non-tension hydrocele in pediatrics, it is customary to adhere to watchful waiting and dynamic observation. In most cases, such a hydrocele does not require medical intervention and goes away on its own as the peritoneal process obliterates. With reactive hydrocele in boys, treatment of the underlying disease is necessary. Tense hydrocele in boys requires puncture of the hydrocele and removal of fluid from the membranes of the testicles. However, in this case, there is a high probability of re-accumulation of fluid in the scrotum and the need for repeated punctures.
Surgical treatment of congenital hydrocele is recommended at the age of 1.5 – 2 years; post-traumatic - after 3-6 months. after injury. Surgical treatment in boys under 2 years of age is indicated when hydrocele of the testicle is combined with an inguinal hernia; recurrent rapidly growing tense hydrocele; hydrocele infection.
For non-communicating hydrocele in boys, Winckelmann, Lord or Bergmann operations are performed (in children over 12 years old). In case of communication between hydrocele of the testicle and the abdominal cavity, a Ross operation is performed (ligation of the peritoneal process and formation of a path for the outflow of hydrocele). Recurrences of hydrocele in boys occur in 0.5-6% of cases, more often in adolescence.
Hydrocele of the testicles in newborns
Hydrocele in newborns is a disease during which fluid is retained in the testicles or excess fluid forms.
Causes of hydrocele in newborns
The fact is that during the development of the fetus, while still in the womb of the mother, part of the peritoneum moves into the scrotum with the testicle. It is called the vaginal process of the peritoneum. Over time, the opening of the vaginal process becomes overgrown, but if this does not happen, fluid begins to collect there. Sometimes fluid circulates from the hydrocele into the abdominal area. Sometimes dropsy of this kind can disappear on its own if the peritoneum becomes overgrown. The volume of fluid that accumulates in the scrotum ranges from a couple of millimeters to one to three liters! This is a common disease in both adults and children.
Symptoms of hydrocele in newborns
The fluid accumulates slowly, but sometimes the accumulation can occur intermittently. You can palpate a pear-shaped formation, the narrowed apex of which is directed towards the inguinal canal. It happens that fluid enters the inguinal canal. This type of hydrocele in newborns is shaped like an hourglass.
Treatment of testicular hydrocele in newborns
Hydrocele of the testicles in newborns can develop in two ways:
The main task when caring for a baby on the part of parents is mandatory monitoring of the development of hydrocele. It is necessary to undergo an examination by a surgeon; perhaps the child will be prescribed an ultrasound examination. Thus, when hydrocele of the testicles is detected in newborns, the main treatment tactic is waiting.
In cases of complications of the disease, expressed by the presence of pain in a child and an inguinal hernia, as well as a progressive increase in testicular hydrocele in newborns, treatment consists of immediate surgery. The operations performed for this purpose are quite simple and safe, but in newborns they are performed in a hospital setting. The entire operation takes less than 40 minutes and is performed under general anesthesia. Surgeries for hydrocele are usually well tolerated by both adults and children.
Questions and answers on the topic "Hydrocele or hydrocele"
Question:After surgery for hydrocele in an elderly man, the testicle became enlarged again. Causes, treatment.
Answer: Hello! The recurrence rate of hydrocele is 5%. The likelihood of developing recurrent hydrocele depends on many factors: the type of hydrocele and the treatment method chosen for it, the causes of the disease, etc. Contact your doctor.
Question:Does hydrocele cause pain to a newborn?
Answer: Hello! No, testicular hydrocele does not cause pain to the newborn.
Question:Hello! What complications occur after surgery for hydrocele?
Answer: The overall risk of complications ranges from 2 to 8%. A particularly high percentage of relapses is observed when operations are not performed on time. Relapses of dropsy occur with a frequency of 0.5 to 6%. In adolescence, relapses of dropsy are more common. The risk of infertility after such operations may be a consequence of surgical trauma to the vas deferens and averages about 2-5%. One of the complications is high fixation of the testicle, when during the operation the testicle is pulled up to the inguinal canal and is subsequently fixed there with scar adhesions. Testicular atrophy is rare and is associated with impaired blood circulation in the testicle, which occurs during mobilization of the peritoneal process from the elements of the spermatic cord. Sometimes in the area of the postoperative scar, unpleasant or painful sensations are noted - hyperesthesia, associated with pinching in the scar or damage to nerve endings. These phenomena usually disappear 6-12 months after surgery.
Question:Hello! What operations are performed for hydrocele in children?
Answer: The type of operation depends on the age of the patient and the characteristics of the dropsy. For communicating dropsy, as a rule, the Ross technique is used - isolation of the elements of the spermatic cord from a small incision in the groin area, excision and ligation of the peritoneal process at the internal inguinal ring, as well as the formation of a “window” in the membranes of the testicle. The operation is delicate, requiring good technique - careful and careful preparation while preserving all the anatomical formations of the spermatic cord - the vas deferens and testicular vessels, as well as the inguinal nerve. Laparoscopic operations are sometimes used for testicular hydrocele, but the morbidity, risk of relapses and complications when using them are higher, and the duration of anesthesia is longer, so they are not widely used. For isolated versions of hydrops, operations on the testicular membranes are used, for example, Bergmann and Winkelmann operations, performed from an incision in the scrotum area.
Question:Hello! A 5-year-old boy has testicular hydrocele, surgery was scheduled in 3 months, is it necessary now (before surgery) to limit physical activity and cycling?
Answer: Hello. Depends on the size and type of hydrocele.
Question:Hello! My son is 2 years old, from birth we were diagnosed with hydrocele of the right testicle, recently an ultrasound showed communicating hydrocele, but our surgeon told us not to do the operation yet, it could take up to three years! I heard that if dropsy does not go away in the first year of life, then it will not go away on its own. I watch and it seems to me that the testicle is getting bigger, but not always, mostly in the evening! Tell me what to do, do the operation or wait?
Answer: It is normal that when there is hydrocele in the testicle, it increases in size in the evening and decreases in size in the morning. Your age already allows you to operate; the dropsy will not go away on its own; surgery is definitely needed here.
Question:Hello, our boy has developed hydrocele since birth. Now he is one year and nine years old, three months ago my husband discovered that it had become bigger. We went to the doctors (a surgeon and a urologist) and they unanimously said that we needed to operate. I was already starting to get upset. However, in our city such operations are not performed, and in the clinic where they are performed, they said that the operation can only be done after three years! Could it be that it goes away on its own? Is it overgrown, or what?
Answer: If the volume of the hydrocele is small, it is not tense, you can wait up to 3 years, nothing bad will happen.
Question:Could doctors have confused testicular hydrocele or a hernia with a cyst?
Answer: This depends on the qualifications of the doctors who made the diagnosis. If you have no reason to trust your doctor, consult another specialist.
Question:Hello! My husband has hydrocele of the left testicle, could this be the cause of childlessness?
Answer: Hydrocele of the testicular membranes on its own, as a rule, is not a cause of infertility. The real reason is something else.
Question:Hello! Can hydrocele of the testicle be bilateral?
Answer: Yes, testicular hydrocele can be bilateral, but more often hydrocele develops on one side.
Question:What to do if, after treatment of varicocele, hydrocele develops?
Answer: You need to contact a urologist, who will most likely prescribe an ultrasound of the scrotum. Depending on the amount of fluid accumulated between the membranes of the testicle, repeated surgery is possible. In this case, the fluid is removed through an incision, and then the testicular membranes are sutured. However, most often, hydrocele (hydrocele) disappears over time on its own: additional lymphatic vessels develop, and fluid leaves the testicular membranes.
Sometimes parents, while bathing or swaddling the baby, notice that one of the boy’s testicles is larger in size relative to the other. This should alert you and prompt you to continue a visual examination of the child. If, in addition to the enlargement of the testicle, a bluish-tinged fluid is noticeably visible through the scrotum, it is necessary to show the boy to a doctor, who will most likely diagnose testicular hydrocele in the child. Despite the frightening name, there is no need to be scared or panic; first of all, ask the doctor what kind of disease this is and whether it can be cured. After examining the baby, if necessary, the doctor will prescribe treatment aimed at eliminating this pathology.
Features of the disease
Hydrocele of the testicle and spermatic cord is a disease that is known in medical terminology as hydrocele. This is a disease of the genital organs, often found in men. They get sick. In order to prevent undesirable consequences in the future in the form of disorders of the endocrine system, male infertility, even testicular cancer, it is important to diagnose the disease in a timely manner and begin the necessary treatment.
Making the correct diagnosis is not so easy, since hydrocele in most cases does not manifest itself with any symptoms or has symptoms similar to other diseases. The pathology can be congenital or acquired.
Attention! As the disease develops, there is an accumulation of fluid between the membranes of the testicles. You can notice the pathology by comparing the sizes of two testicles; one of them will be increased in size. In this case, the size of the testicle increases from three millimeters or more.
A funiculocele is the development of dropsy in the area of the spermatic cord, which is located between the inguinal ring and the testicle. The clinical picture of the pathology is similar to hydrocele, with the difference that the accumulation of fluid is noted along the spermatic cord. The disease develops as a result of injury.
Forms of the disease
In medical practice, the following forms of hydrocele are encountered:
- isolated;
- communicating;
- communicating, which is combined with an inguinal hernia.
Read on and how it can manifest itself on other parts of the body.
Isolated
An isolated form of pathology in infants appears as a result of birth injuries; the cause of the disease is swelling of fluid from the scrotum. The disease is characterized by simultaneous damage to two testicles. If intense swelling is noted during the development of the disease, a puncture is prescribed, with the help of which the fluid is extracted.
This form of the disease manifests itself in young children in the first months after birth; in most cases, the pathology goes away on its own before one year. In adolescence and in adults, the disease is the result of injuries, hypothermia, and urination outside in windy weather.
The development of an inguinal hernia in children occurs due to a non-overgrown vaginal process. When the process of the peritoneum is open, fluid from the abdominal cavity and sometimes organs located in the abdomen (intestinal loop, omental strand, and in girls, appendages) enter it.
Important! In childhood, the development of this form of pathology occurs in extremely rare cases; it is rather a disease of adults, which occurs as a result of stress and defects of the abdominal wall.
Communicating dropsy
Communicating hydrocele in children is a pathology characterized by the free passage of fluid from the abdominal cavity into the scrotum, as well as its movement in the opposite direction. The pathology is the result of a non-overgrown vaginal process of the peritoneum. Today there are many theories about why infants develop this form of the disease. During the research, scientists came to the conclusion that the structure of the open vaginal process of the peritoneum includes smooth muscle fibers, which complicate the process of overgrowth of the process of the peritoneum.
Attention! According to statistics, reported hydrocele of the testicles in newborn boys is observed if the pregnancy proceeded with complications and the threat of miscarriage. Pathology is also often observed in premature male infants.
In some cases, communicating hydrops can develop into an inguinal hernia or inguinal-scrotal hernia. Causes of pathology:
- excessive excitability, restlessness of the baby;
- intestinal problems.
As a result of the restless state of the baby, intra-abdominal pressure increases, as a result of which the abdominal process and inguinal canal expand, which leads to the development of pathology.
How does the disease manifest itself?
Hydrocele of the testicle is a common pathology of newborn boys; as a rule, the symptoms go away on their own during the first two years. If this does not happen, the intervention of a specialist will be required, who, after examining the child, will prescribe an ultrasound examination and the necessary treatment procedures.
Symptoms of the disease are almost unnoticeable, except for the testicle, which is enlarged in size. Fluid accumulates in the testicle with varying intensity, sometimes slowly, then abruptly, and at other times sharply.
How to recognize the disease in order to prevent complications? If you put the baby in a horizontal position, the swelling is almost unnoticeable; it appears when you ask the child to inflate or tense his tummy. On palpation of the scrotum, a pear-shaped formation of different sizes is noted.
Remember! For the normal development of sperm, certain temperature conditions created by the membranes of the testicles are necessary. Dropsy is a kind of membrane that tends to change the conditions for the development of sperm, and often not for the better. We must not allow the disease to progress, because this is a sure path to infertility.
Treatment methods
Many parents are concerned about the question of when does hydrocele in newborns go away and how to treat the disease? Doctors say that if the pathology is congenital, no therapeutic measures can be taken until the baby is two years old. As a rule, during this period the pathology will disappear on its own, without treatment procedures. If there is excessive accumulation of fluid in the testicles and the child is restless, a puncture is prescribed. The procedure involves withdrawing fluid from the scrotum with a syringe.
Operation
Surgery is an extreme option that is required if the size of the hydrocele has changed significantly. Surgical intervention consists of permanently removing the dropsy; it will help avoid complications such as the formation of an inguinal hernia.
Today, surgical treatment is carried out using the following method:
- Winkelmann;
- Bergman;
- Lord's.
Parents! Treatment without surgery is impossible in case of combination of dropsy with an inguinal or inguinal-scrotal hernia. The operation is prescribed for children aged 1-2 years.
Drug therapy
Typically, the development of hydrocele in childhood goes away on its own. To prevent complications, the child should be under the supervision of a pediatric urologist until the signs of the disease completely disappear.
At an older age, if hydrocele is accompanied by pain and swelling, drug treatment is prescribed. Doctors recommend taking non-steroidal anti-inflammatory drugs. If the pathology is accompanied by infection, antibiotics or antiviral agents are prescribed.
Attention! Hydrocele of the testicles in adolescence is very dangerous, so you should not self-medicate. The taking of medications and their dosage should be prescribed by the attending physician.
Traditional methods
Many mothers, when faced with a problem, immediately run to their grandmother or neighbor for advice and ask what folk remedies they use to treat an unpleasant illness. This decision is wrong; expert advice is needed here.
Attention! Treatment of young children with folk remedies does not give positive results, no matter how miraculous the herbs, infusions, and lotions are. Traditional treatment can only be used if the child is over 10 years old, and then only on the preliminary recommendations of the doctor.
It is known that pharmaceutical chamomile is used for hydrocellus to relieve inflammation and prevent the spread of infection. Stinging nettle is used for the same purposes. Birch buds, from which a decoction is prepared for oral use, provide a good therapeutic result.
Untimely treatment of dropsy threatens complications in the form of enlargement of the scrotum, the development of chronic inflammatory processes in the body, necrosis of nearby tissues - this is at best, and at worst, the disease will lead to infertility. Timely detection of pathology and treatment will ensure your child a healthy and fulfilling adult life.
