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A hydrocele (hydrocele) is a dense tissue sac with fluid that forms around the testicle and as a result leads to a change in the size of the scrotum unilaterally or bilaterally. A hydrocele can often be visualized in newborns, and in most cases dropsy disappears without the need for outside intervention before the baby is one year old. At a later age, dropsy of the testicle can be formed through trauma or inflammation of the scrotum.
The disease can develop without accompanying pain syndromes. Often, medicinal or surgical intervention is not necessary when dropsy is detected, since it is completely safe for the human body. But in the event that edema is formed and the scrotum has increased significantly in size, it is necessary to contact a urologist or surgeon in order to determine the cause of its formation and outline further actions.
Signs and symptoms of hydrocele
The main indicator of the development of a hydrocele is a painless accumulation of fluid around one or both testicles, as a result, a change in the size of the scrotum is observed and discomfort appears. Sometimes the severity of dropsy changes during the day: in the morning it is small, in the evening it increases.
When to See a Doctor
Adults should visit a urologist or surgeon if an enlarged testicle or scrotum is visualized. During the examination, the doctor will exclude the possibility of the presence of other causes of the appearance of such symptoms. In some cases, an “open” hydrocele is a consequence of the presence and enlargement of an inguinal hernia. In this case, the problem is urgently corrected through surgical intervention.
If a child has swelling or an increase in the scrotum, it is necessary to immediately show it to a pediatrician, urologist or pediatric surgeon. In the event that the presence of a small dropsy of the testicle is determined before the age of one year of the child, they do not touch it. If it does not go away at an older age and increases in size, an additional examination is carried out, after which the doctor issues a referral for an operation to remove the dropsy of the testicle.
Causes of hydrocele development
There is a possibility of the formation of dropsy of the testicle in boys even during fetal development. Usually during the period of development of the child from the abdominal cavity, the testicles descend into the scrotum. It is worth noting that each testicle has a vaginal process of the peritoneum, which, in turn, allows fluid to accumulate around them.
Most often, this sac closes, and fluid from the abdominal cavity cannot enter the scrotum. But if, nevertheless, a small accumulation of fluid is visualized around the testicle after the sac is closed, such a condition is diagnosed as a “closed” hydrocele. The pouch is in a closed state, and the fluid cannot return to the abdominal cavity back. Basically, the testicular membranes absorb this fluid during the first 12 months of life.
There are situations when the sac remains open, which is fraught with an increase in fluid in it and visualization of an increase in the scrotum. A decrease in the size of dropsy in the morning is due to the fact that the fluid periodically returns to the abdominal cavity, and then drains back into the scrotum.
In adulthood, the formation of dropsy of the testicle can provoke:
- inflammatory disease – epididymitis orchitis, orchitis, epididymitis;
- scrotum injury;
- complication after surgery for varicocele.
Risk factors for hydrocele
Most often in children, dropsy of the testicle is congenital. Premature babies have a high percentage of the likelihood of hydrocele. Of the risk factors, it is worth noting: infections, among which are sexually transmitted; injuries of the scrotum and groin area.
Complications of hydrocele
Education is usually safe for the body and does not affect reproductive function. But still there are cases with the manifestation of serious complications.
An inguinal hernia is a life-threatening condition when a loop of the small intestine enters the scrotum through a weakened area of the abdominal cavity and is pinched.
Infected hydrocele – the presence of an inflammatory process in the scrotum. Infection can develop after the puncture, the fluid in the dropsy begins to rot. This condition is corrected through surgery, in some cases, the removal of the testicle itself is required. Most often, the functionality of the testicle after infection is significantly reduced.
There are cases when dropsy of the testicle masks the development of oncological formation.
Inspection and diagnostics
During the visual examination, the doctor presses on the lower abdomen of the patient. If the scrotum increases in size, there may be a communicating hydrocele or an inguinal hernia.
For diagnosis, diaphanoscopy can be used – since the liquid in the dropsy is transparent, the doctor can examine the testicle in the lumen. If the testicle is not clearly visualized, this is an indicator of the presence of an infection or other disease.
In parallel, a blood and urine test is taken from the patient to determine the presence of an inflammatory process in the body.
Sometimes doctors prescribe an ultrasound for a more accurate diagnosis. With the help of this study, it is possible to exclude or confirm the presence of a tumor, hernia and other pathological diseases that provoke an increase in the scrotum.
Algorithm for the operation of hydrocele
Most often, men undergo surgery in adulthood, when there is an increase in the size of the scrotum and other pathological changes.
Hydrocelectomy is an excision of dropsy of the testicle, performed on an outpatient basis under local (spinal or general) anesthesia. An incision is made either in the lower abdomen or on the scrotum. If dropsy is detected during the operation to eliminate the inguinal hernia, the surgeon removes it along the way, even if it does not visually pose any danger. After the operation, the patient must regularly wear a special tight bandage or compression underwear. Immediately after surgery, an ice pack is applied to the incision site to reduce swelling. Surgery can cause blood clots to form in the scrotum, infection of the wound, and damage to the testicle itself.
A safer option is a puncture. Using a long needle, the scrotum is gently pierced, all fluid is removed by gravity through the needle and silicone tube. This method is ideal for men with a disease of the cardiovascular system and with the presence of problems with blood clotting. Among the risks is the possibility of infection of the scrotum.
Among modern techniques, it is worth noting the use of a laser during the operation. Laser excision is a safe procedure without bleeding and the possibility of infection in the scrotum or wound.
Dropsy can recur after treatment, it is important to diagnose it in a timely manner and seek the advice of a doctor.