Hydrocele symptoms and syndromes
Hydrocele - a cluster of serous fluid between the sheets of the serous membrane of the testicle, congenital or acquired nature. Some authors attribute the appearance of hydrocele (hydrocele) with physical labor, often with horse riding (riders) and cars (drivers).
Hydrocele (hydrocele) may be limited to only the area of the egg, keeping in this case, egg-shape of the tumor. An increase in hydrocele (hydrocele) may take part and shell cord, and the tumor is pear-shaped, with a sharp end facing to the inguinal canal. In the presence of scar constrictions on the spermatic cord (congenital or acquired nature), hydrocele (hydrocele) gets an hourglass shape: one bag in the scrotum, the other under the skin in the inguinal canal.
Anatomy of the male genitalia.
When a hydrocele (hydrocele) by type of hourglass inner bag located in the abdominal cavity, communicating with the outside through the cleft vaginal process of peritoneum.
In the presence of inflammatory adhesions between two sheets of serous membrane, formed Multi-hydrocele (hydrocele). With congenital hydrocele (hydrocele) no obliteration of the vaginal processus peritoneum, and the liquid can move freely from the scrotum into the abdomen and back.
During hydrocele (hydrocele), there are two forms - acute and chronic.
Acute hydrocele (hydrocele), or acute periorhit develops within a few days and kept in one position for 1-2 weeks in order to then disappear or go into a chronic form. Clinically, acute hydrocele (hydrocele), a tumor half of the scrotum. On the skin of the scrotum in acute hydrocele (hydrocele) can be observed spilled red with edema. Swelling of the scrotum in acute hydrocele (hydrocele) is elastic, clearly fluctuant.
Scrotum in acute hydrocele (hydrocele), percussion gives a dull sound, the light shines, very sensitive. Test the egg, otdavlennoe backwards, you can not. Acute hydrocele accompanied by a significant rise in temperature is observed, usually as a result of traumatic or ostrovospalitelnogo process in the epididymis or testis.
Chronic hydrocele (hydrocele) usually develops gradually, little disturbing the patient. Reaching a large, chronic hydrocele (hydrocele), its weight causes pain in the groin, discomfort during intercourse and sometimes during urination. Retraction of the penis into the tumor in chronic hydrocele (hydrocele) can alter the stream of urine, which moisturizes the skin of scrotum, causing her eczema.
Clinically, patients with chronic hydrocele (hydrocele), there is a pear-shaped tumor. The upper boundary of the tumor in chronic hydrocele (hydrocele) is well defined. Skin with small hydrocele is not a change at large - thinned, but movable. Depending on the amount of fluid, the tumor may be severely strained, as a dense stretch of Education, with fluctuations, and it is impossible to test the egg and the appendage. Sometimes the tension of the liquid is so small that the appendage of the testis and a pretty good feel.
Percussion tumor in chronic hydrocele (hydrocele) gives a dull sound and shine. When communicating hydrocele (hydrocele), type the hourglass, which also has a chronic course, the tumor appears only when walking and movements in the supine position, it can go the whole or part.
Scrotal ultrasonography were normal.
Characteristic symptom of hydrocele (hydrocele) is candling, which is produced by flashlight, closely applied to the surface of the tumor, the tumor is opposite of put on a stethoscope. The passage of light rays eliminates hematocele, orchitis, testicular tumors, which differ from the hydrocele is also its roughness. When thickened serosa prosvechivaemost egg shells may also be absent. Large hydrocele (hydrocele), when the process involves the shell and cord, it is necessary to differentiate from hernias.
The prognosis of acute hydrocele (hydrocele) is favorable. In chronic hydrocele (hydrocele), rely on spontaneous healing to occur. When a hydrocele (hydrocele) by type of hourglass in children can sometimes occur subsequent obliteration of the vaginal processus peritoneum with complete cure.
Complications of hydrocele (hydrocele):
- infection of the fluid of endogenous and exogenous (due to a puncture)
- hemorrhage into the cavity of the shells
- rupture of membranes due to injury (and sometimes observed spontaneous rupture)
The cause of rupture of membranes is the loss of elasticity due to chronic inflammation of the membranes. Specific localization of the gap there. Experiments indicate that the rapid increase in hydrocele often helps break.
Prevention of complications of hydrocele (hydrocele): wearing jockstrap for any urogenital diseases.
Conservative treatment of hydrocele (hydrocele) is shown in the acute and rapid in chronic cases. Conservative treatment was reduced to the application can warm compresses on the scrotum.
Radical surgery for hydrocele (hydrocele):
- According to Bergman (Vegdtapp): longitudinal section through all layers of the scrotum to the serous membrane of the testicle, not cutting it. Luxating testicle into the wound. Cut the bag and resecting the outer layer of serous membrane around the epididymis. Meticulous hemostasis. Egg is laid in place. Deaf seams. Method is recommended for thick shells.
- According to Winkelmann (Jaboulay-Winkelmann): cut along the front outer surface of the scrotum through all layers down to the serous membrane, breakdown of the eggs in the wound. Serosa incision up and down to the tail of the epididymis. On the inverted hull seams, behind the epididymis. Deaf sutures on the skin. Relapses in 1-2%. Way, almost giving the complications, is popular, removes the patient from work for short periods.
- Alferov way: cut all the shells, deflation fluid. With a view to a permanent drainage hem serosa to the subcutaneous tissue of the scrotum. Deaf suture the skin. Bandage.
If you have any questions about the diagnosis or treatment of hydrocele (hydrocele), you can specify them with our urologist or a nephrologist poozvoniv by phone: +7 (926) 988-14-23
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