Whether the operation of Russia to the hydrocele is needed?

Removal hydrocele via Ross operation

Ross Operation with hydrocele (hydrocele) - one of the traditional surgical techniques.

Contraindications to carry it out are not available, except for the low rate of blood clotting and chronic pathologies on dekompensatsionnyh stages.

The procedure is performed in a specialized hospital, its length does not exceed 40 minutes. Postoperative scars are almost invisible. Among the shortcomings - the need for general anesthesia.

Indications for

Operation Ross appointed routinely boys older than 2 years of age diagnosed with communicating hydrocele. In this form of congenital pathologies fluid freely flows through unjoint (neobliterirovannomu) vaginal sprouting shells from eggs into the abdominal cavity.

A characteristic feature is the presence of the elongated soft formation, the upper edge of which is detectable at the external inguinal ring. On the morning of the scrotum may be of normal size, and in the evening increases. The goal of surgery is the relief of communication between the testicles and the peritoneum membranes, creating a channel for the outflow of fluid.

In 80% of cases of vaginal process of obliterating their own in the first 1.5 years of life, so urologists prefer to expectant management during the period. Operation Ross in boys younger age in the following cases:

• complications: signs of testicular atrophy, joining an inguinal hernia;
• constant sharp pain;
• increase of the scrotum, preventing normal movement.

Recent symptoms characteristic of acute edema which developed. When flat (progradiently) recommended course of disease during the surgery with 1.5 to 2 years.

Preparation for the procedure

Preparation includes a standard set of laboratory studies of blood:

1. Group and Rh factor.
2. General and biochemical analysis.
3. Coagulation.

Also dealt urinalysis.

In identifying acute inflammatory or infectious diseases surgery deferred until full recovery. After discharge is given 2 weeks on the body's recovery.

6 hours before the procedure, the child can not eat, the latter fluid intake should be 2 hours. Against the background of anesthesia relaxation of the esophagus with a full stomach can lead to penetration of food into the airway (aspiration).

According to the survey the doctor chooses the tactics and the type of anesthesia, as well as giving advice on the preparations for the operation.

technique of

Operation Ross - a delicate type of surgery requires a doctor of good technique. Dissect the tissue should be as carefully as possible, to keep the spermatic cord, inguinal vessels and nerve.

With appropriate equipment and personnel intervention is done minimally invasive endoscopic access - laparoscopic hernia repair. In this case, the course of the following operations:

• in radius umbilical ring mounted optical trocar (thin hollow tube);
• pneumoperitoneum performed (procedure gas injection into the peritoneal cavity);
• at 3 cm from the navel trocar introduces two workers;
• into the abdominal cavity of the manipulator 2 are omitted and a special thread atraumatic needle;
• area of ​​internal inguinal ring is examined for the presence of the liquid, when detecting its evacuated;
• processus vaginalis sutured purse-string suture.

In the traditional method of intervention in the groin incision is made through which the physician gets access to the spermatic cord. Then the vaginal selection process, its ligation at 2 points and subsequent excision of the docked segment. In order to ensure drainage in the shell egg is left a small gap. Tissue sutured in layers bioresorbable sutures.

Most doctors tend to the traditional method as a less traumatic, does not require long-term anesthesia. According to statistics, the percentage of complications and recurrences after laparoscopy is higher, so this method is rarely used for children.

The operation lasts an average of 25 to 30 minutes. Even after the intervention of the traditional method of cavity is almost imperceptible cosmetic seam.

rehabilitation period

After the operation of the child is outputted from anesthesia (average process takes 40 minutes). When consciousness and reflexes are restored, it is transferred under the supervision of a specialist. The child indicators homeostasis are gradually recovering, and psychophysical features.

After 4-5 hours can be taken liquid food, and water. For full adaptation will require about 10 hours of stay in the hospital under medical supervision. If all indicators are normal, the patient is discharged under the control of local pediatrician.

During the first day the child may disturb pain, for the relief of which prescribed Ibuprofen or Paracetamol. Temperature may rise (+ 37... 38 ° C) - this is a normal reaction to the anesthesia. Baths may be taken 72 hours after surgery.

In the first 10 days should limit physical activity boy. Gentle treatment persists for months (school free from physical education). Not allowed squeezing the scrotum (underwear, tight swaddling, bike riding).

It is important to avoid the occurrence of constipation and other factors to increase intra-abdominal pressure. Child desirable to translate light table, comprising a large number of fiber (vegetables, fruits, cereals). To avoid problems with a chair, some doctors immediately prescribe a laxative for 4-5 days after surgery.

During the year shown dispensary observation. After 6 and 12 months recommended holding ultrasound of the scrotum to control testicular volume and blood flow rate.

complications

The overall risk of complications after surgery for hydrocele is from 2 to 8%. Relapses occur in 0.5-6% of cases. The risk of re-development of hydrocephalus increases proportionally to the time delaying operation. Timely removal pathology and correct technique of the procedure significantly reduce the possibility of adverse reactions.

After surgery the following complications may occur:

• lasting pain or fever;
• bruising and swelling of the scrotum (often non-compliance with the recommendations on rehabilitation);
• infection seam area;
• inguinal nerve damage, thereby reducing the sensitivity of the inner surface of the femur;
• hyperaesthesia - pain caused by injury or scar infringement nerve endings extends within 6-12 months;
• Testicular atrophy occurs in the case of circulatory disorders in the separation process of the vaginal spermatic cord.

Testis after surgery can be tightened up and fixed in this position cicatricial seam. Subsequently, it will require a forced relegation. There is also the risk of late complications such as decreased libido or infertility (in case of damage of the vas deferens).

In most cases, children do not arise adverse reactions after surgery Ross provided its correct execution. Subject to the terms of treatment and doctor's recommendations favorable prognosis.

prevention

Protect children from prenatal development communicating hydrocele is not always possible. The risk increases with unfavorable proceeding pregnancy, premature birth. In part we can only affect one factor - the increased intra-abdominal pressure that occur during physical exercise or frequent crying child.

With regard to the prevention of postoperative recurrence, it is important to avoid crushing or injuries perineum, physical overload. Any accumulation of exudate or blood can lead to the re-development of the pathology. Antiseptics Ranque be processed and maintained in a clean and dry state.

Delays in the adoption of hydrocele treatment measures involve hypoplasia of the testis, disruption of spermatogenesis, which will significantly reduce the chances of paternity. C. Ross operation associated low percentage of complications and relapses, however should not delay its execution, leading to the pathology of chronic stage.

A source: https://venerologia03.ru/yaichki/operatsiya-rossa-pri-vodyanke.html

Ross Operation with hydrocele in children: indications, preparation, performance technique

The accumulation of excess fluid in the membranes of the testicles is called "hydrocele". The disease is characterized by swelling in the groin area, and a significant increase in the volume of the scrotum. Deviation may occur both in adult males and refers to congenital anomalies.

Ross Operation with hydrocele

Surgery is performed in congenital pathologies of the boys after they reach 2 years. The main aim of the operation is the creation of additional apertures for the outflow of liquid accumulated with edema, removing excessive pressure on the testes.

The advantage of the technique is the absence of contraindications to, for a short time intervention (40 minutes) and minor post-surgical scars. The negative side is the need of the child in deep anesthesia and the possibility of recurrence of the disease.

For the treatment of hydrocephalus in adults other exposure techniques are used.

Indications for

Surgery is recommended in the following situations:

• confirm the presence of communicating hydrocele in children after 2 years of age;
• increased sizes testicular impeding free movement;
• diagnosed complications;
• pain constantly present in the groin;
• the probability of developing subsequent futility.

Communicating hydrocele different specific feature - while supine liquid overflow occurs in the region of the peritoneum, thus there is a reduction in the size of the scrotum.

Surgical intervention techniques Ross with edema has virtually no restrictions on the application. The only contraindication to manipulation is a low rate of blood clotting.

Training

Experts recommend that parents spend preoperative preparation of the child with the definition of health. If a baby has recorded colds or infectious disease, the Ross operation is delayed for a month. Postponement of the date the operation is associated with possible complications - the development of inflammation or pneumonia.

Advance undertake clinical blood and urine tests - it is determined by the overall condition of the body. Six hours before the surgery, the baby can not receive food and water.

course of the operation

The main goal is pursued by removal techniques nonstandard flow between the peritoneum and the testes, while generating a discharge channel for the normalization of fluid.

Ross Operation with hydrocele children is carried out in three stages:

Introduction to general anesthesia - avoiding the psychological trauma of the child and hold manipulation without pain.

Operation - Select the incision depends on the existing comorbidities. When the access is inguinal hernia in the groin area - for the treatment of joint problems (correction of the main goals and suturing hernia). In uncomplicated embodiments specialist injects through scrotal tissue.

After vaginal incision extracted outgrowth ligated at two points and excised. Following formation of the holes occurs to remove excess liquid. The procedure ends superposition suture which independently dissolves to the extent of wound healing.

Exiting narcotic sleep - after the installation of drainage and blending patient seams begin to withdraw from anesthesia.

The total time of the procedure does not exceed 40 minutes, observation of the patient is carried out for 10 hours in a hospital. The postoperative period is held in the home, under the constant supervision of a pediatrician.

complications

The negative reaction of the organism (in surgical manipulation) divided into early and late complications. First appear in a few hours or days, the second - can have an impact over the years.

By frequently encountered symptoms include:

• pain in groin - continuing for about a week and if there are movements;
• tissue edema and hematoma around the joints;
• problems with the natural urination;
• fever;
• purulent and inflammatory processes in the weld region - penetration of the infection;
• sensitivity decrease from the inner side of the thigh - with inguinal nerve damage.

By late complications include low sex drive, infertility. Manipulations does not guarantee the impossibility of forming a relapse. Secondary hydrocephalus occurs in rare cases - in violation of technology operations.

Rehabilitation period requires more attention to the child by the parents. The first day after the operation the child may complain of discomfort - to suppress the negative manifestations experts recommend the right choice of clothes, non-water treatment (within three days), reception "Ibuprofen" or "Paracetamol".

Physical activity, access to water should be limited. Children should not touch the surgical site, watering it. After resorption suture material Child continued to drive on preventive examinations of a specialist.

Swelling in the groin area subsides within one month. To reduce the risk of recurrence, parents should adhere to preventive measures. Kid transferred to a separate table that includes natural honey, lemons, pumpkin, eggplant, cabbage.

Postoperative favorable prognosis. For the purpose of warning the formation acquired hydrocele necessary to prevent injury in genitals, to comply with personal hygiene, time to treat infectious and inflammatory processes.

Hydrocele testes in children under one year are sometimes held their own. In connection with this feature of surgical interventions are carried out after two years of age.

Caution! The video performance of the Ross operation (click to open)

A source: http://gidmed.com/urologiya/lechenie-urolog/hirurgicheskoe/operaciya-rossa.html

Operation with hydrocele

Hydrocele or a hydrocele of the testes is the second largest non-communicable diseases of the male genital organs. Illness is a pathologic accumulation of serous fluid in the scrotum.

In children, it is most often formed because of the innate physiological uncovered pockets, formed by the omission of the testicles from the abdominal cavity. In adult males the accumulation of lymph in the cavity causes are:

• mechanical damage to the body;
• overvoltage when lifting weights;
• infections of the genitourinary system;
• after removing the effects of an inguinal hernia or treatment of prostatitis;
• tumors of genitals;
• testicular torsion;
• morbidity of heart failure.

The disease is in the early stages of development lends itself to conservative treatment, but with the deletion of a provoking factor. If, however, a significant accumulation of fluid, then resort to surgery. Operation performed when hydrocele testis surgeon urologist in several ways, each of which has its own advantages and disadvantages.

Source: dr-ryabov.ru

Training

Whichever method of surgery has not been selected, the patient must undergo a series of diagnostic tests. First performed ultrasound of the scrotum and surrounding blood vessels. The procedure allows to refine the form hydrocele, the amount of the accumulated liquid, and also verify the absence of testicular inflammation or.

Additionally appointed transillumination - a sick testicle through a beam of light is passed. Diagnostic method helps to identify the nature of the fluid or the presence of a tumor.

Since the operation at a hydrocele is performed under local or general anesthesia, the patient undergoes preoperative established list of research:

• general analysis of blood and urine;
• blood chemistry;
• Blood tests for infection (HIV, hepatitis, syphilis);
• electrocardiogram;
• fluorography;
• coagulation.

In the presence of chronic diseases, for surgery requires permission of the attending physician conducting a clinical account.

Normally, surgery to remove the hydrocele carried out in a planned manner, so for 2-3 days before the scheduled date of the patient must adhere to a special regime.

From the diet excludes all gas-products and alcohol, stop taking certain medications (a list can be found at the doctor), held hygienic shave the groin area. 6-8 hours prior to surgery a complete refusal to eat and drink.

Puncture

This treatment method is considered to be a temporary solution, helping to simply remove a significant accumulation of lymph in the scrotum. Puncturing is performed in the following cases:

• impossible to classical interference;
• you need to quickly improve the condition of the patient and eliminate the aesthetic issues;
• I had a relapse of the disease;
• young child patient (as delaying elective surgery).

Surgery to remove the hydrocele performed under local anesthesia and is a puncture needle testicular membranes followed by aspiration of accumulated secretions. In place of the puncture sterile dressing is applied, and after 5-6 hours the patient leaves the hospital. Followed by wound treatment is not required. Complete healing of tissues occurs on day 2-3.

For elderly patients, loss of reproductive function, modern medicine offers an innovative method of treatment - puncturing followed by sclerotherapy tissue.

The essence of it is easy: after removal of the liquid contents of the scrotum is introduced into the cavity sticking agent that blocks the space for accumulation of pathological secretions. Such surgical treatment of hydrocele reduces the risk of recurrence of the disease up to 1%.

Winckelmann

The intervention is quite complex, so is performed under general anesthesia. At the beginning of the surgeon cuts 3-5 cm skin fold and an outer shell eggs. After all remaining incise tissue and serous carried suctioning secretions. To reduce the twisted inside the area membranes wound edges and sewn behind the organ.

If necessary, install drainage. At the end of the operation is superimposed sterile dressing and ice pack for 1-2 hours. The patient can leave the health facility for 2-3 hours. If Winckelmann operation is not absorbable catgut strings, the removal of sutures is planned for 10-14 hours. Until that time, do daily bandaging the wound with sterile material change.

Bergman

Operation during hydrocele similar technique to the previous execution, the only difference - instead tissue eversion is produced, followed by their excision wounds drenazhirovaniem.

The method is more traumatic and strongly recommended when pronounced thickening of the walls of large gathering eggs or liquid when scrotal tissue are unsightly. In the postoperative period, the patient is shown wearing a jockstrap, which helps maintain the scrotum and removes the burden from the spermatic cord.

by Lord

Considered the low-invasive type of surgery in the treatment of hydrocele in both children and adults. For anesthesia performed obkalyvanie local anesthetics tissue. The incision is made on the dropsical tissue bag to evacuate secret. After the egg is raised, and vaginal membranes are subjected to crimping (plication).

Advantages of the method of operation Lord:

• minimal risk of complications;
• offline traumatizing the vessels and tissue of the scrotum;
• speed of execution;
• no aesthetic defects;
• shorter rehabilitation period.

A significant drawback of this method of treatment - the possibility of re-emergence of the disease. Sometimes surgery is necessary to do several times.

Ross

Ross is most effective surgery for hydrocele in children, because it allows you to eliminate the inherent nature of the disease. It is performed only after 2 years of age.

Technique of the following:

• an incision is made in the groin;
• intersects processus vaginalis;
• for liquid outflow opening formed in the inner shell;
• closed with stitches.

Best of all, if the operation to remove the hydrocele of the child will be endoscopically. This helps to minimize the risks and reduce the rehabilitation period.

Rehabilitation

Operated patients within a year under the supervision of a doctor urologist and undergo regular checkups. In the first days after the intervention is advisable not to sit. If worried about the pain, then take painkillers. Sutures treated with antiseptic and sterile dressings applied. All patients displayed antibiotics and anti-inflammatories.

During the recovery of the body after surgery, patients should observe protective regime: strictly dosed exercise temporarily abandon the sport and sex, wear loose underwear underwear.

complications

Usually after surgery hydrocele effects occur only if you selected the wrong treatment or were low qualified surgeon. Minor complications is considered to offset the eggs, which can be seen even visually. In this case, the patient should consult a urologist for advice.

The most common complications are also:

• wound infection;
• hematoma;
• intersection of the spermatic cord;
• edema;
• infringement of the nerve endings;
• pathological scarring.

2-3 of 100 cases surgery to remove the hydrocele in men gives a relapse, especially if it's done minimally invasive manner.

Summarizing, we note that any of the above methods of surgical treatment does not guarantee one hundred percent positive, without removing the cause of the formation of the disease.

When the hydrocele testis in the child, then surgery is often postponed until better times, and it is fraught with other unpleasant consequences, such as infertility.

A delay in this case, works against the reproductive health.

A source: https://uran.help/surgery/operatsiya-pri-vodyanke-yaichka.html

Operation with hydrocele in children

Hydrocele - a pathological accumulation of fluid around the testicle. In young children, hydrocele presented communicating type. In older children and adolescents can develop isolated hydrocele.

Methods of surgery urologist selected depending on the type of hydrocele.

About the indications and timing of the operation with hydrocele in children you can read in the article "hydrocele in infants 'and' hydrocele in boys."

before surgery

If the child suffered colds a week before the hospitalization, you must replace notify your doctor. In this case, the operation will be delayed. The child should fully recover after the disease as holding anesthesia and surgery on the background of the disease can cause serious infectious complications up to pneumonia.

After the hospitalization of your child is required to examine to exclude the presence of infectious disease.

Blood and urine tests are dealt or admission to the hospital or on an outpatient basis in a few days before the scheduled surgery.

These assays enable the doctor to exclude the presence of infection in the child, and, therefore, provide a safe for anesthesia, operative and postoperative period.

Before the surgery, you will be interviewed operating surgeon and the anesthesiologist, who will explain in detail to you and your child everything that will happen during surgery and anesthesia.

After the talk, you will be required to sign an informed consent for surgery and anesthesia. Before you sign the agreement, make sure you fully understand all you set out information about the treatment and its possible risks.

Do not hesitate to ask your doctor questions you may have.

Your child should not eat or drink for at least six hours before surgery. This means that the use is not allowed even a sip of water. Your child's stomach must be empty, which will provide safe during anesthesia

Anesthesia

The operation is performed under general anesthesia. Parents often ask the question, "Does my child is required general anesthesia or surgery can be performed under local anesthesia?".

General anesthesia is not only safer, but also more humane in relation to children in need of surgical treatment.

Despite the fact that the anesthesiologist can provide pain control during surgery without general anesthesia, it helps avoid the development of a child's psycho-emotional stress caused by the kind of needles, surgical devices, sounds and smells.

General anesthesia means by itself what the doctor pediatric anesthesiologist will use drugs that cause a rapid relaxation of the child and ensure absence of consciousness the whole period operations. Thanks to this, the child will not have any unpleasant memories.

For the implementation of anesthesia is most often used a mask through which the child breathes anesthetic gases. After the child is asleep, he will put an intravenous catheter. Intravenously administered painkillers that provide balanced anesthesia. Respiratory support and oxygen delivery to the child provides the anesthesiologist, the whole operation period conducted observation monitor vital bodily functions (heartbeat, blood pressure and etc.).

Thus, anesthetic, performed by a qualified physician, virtually no danger to the child. After the operation, the supply of anesthetic gas is turned off, and the baby after a few minutes regains consciousness.

Operation

In children with communicating hydrocele performed the Ross operation. Once your child is completely asleep, the surgeon makes a small incision in the groin to visualize the spermatic cord.

Once the surgeon sees the spermatic cord, it gently provide a vaginal process among the other elements of the spermatic cord, and will bind issechet it from the inner hole of the inguinal canal.

Tunica vaginalis testis is excised, or it formed a "window" for the outflow of the fluid, the wound is sutured, impose a sterile bandage. In this operation ends.

If not hydrocele communicates with the abdominal cavity, the operation is performed scrotal access.

In this case the surgeon makes a small incision in the projection on the scrotum hydrocele through which performs the plastic shell eggs of one of the techniques. Then sutured wound.

Sometimes a surgeon may leave the drain in the wound rubber which is removed a day after surgery. Plastic egg shells can be performed by the method of Winkelman, or lord of Bergman.

In step Winkelman egg output in wound hydrocele contents aspirated after dissecting it everts the tunica vaginalis testis and sewn around.

During the operation, Bergman tunica vaginalis is excised as close to the base, and its remnants are edged seams.

Unlike Winkelman and Bergman operations when necessary to output the egg into the wound, Lord surgery less traumatic, since the tunica vaginalis testis is crimped in place.

Operation with hydrocele in children lasts 20-30 minutes.

After the operation - in clinic

A few hours after surgery, the child will be allowed to drink in the evening and there.

Usually you can go home the same day or the next morning.

After surgery, your child likely will not feel any pain. If necessary, you can stop the pain with the help of a non-steroidal anti-inflammatory drug (paracetamol or ibuprofen). Within a few days the wound would not cause any discomfort or pain.

After the operation - at home

Houses try to limit physical activity your child in the first few weeks after surgery, especially if the child is less than five years. You should explain to your child that he should not touch the wound. As sometimes it can not only cause pain, but also lead to infection and bleeding.

If the surgeon sutured the wound with absorbable thread, then over time the joints will disappear on their own. If the wound is sutured non-absorbable sutures, then 5-7 days after surgery, you will need to visit the clinic, where the surgeon will remove the sutures. In my practice, we try to use only biodegradable material in order to avoid such an unpleasant procedure, as removal of stitches.

slight redness that should not bother you the first two days around the wound may occur, but if it persists more than two or three days, you should consult a doctor, as a redness may indicate an infection wounds.

A child can wash, but, nevertheless, try to keep the wound as dry as possible as long as no stitches will be removed.

Possible complications of surgery

Since the operation is performed under general anesthesia, one way or another there is a low risk of anesthesia complications, which may not even anticipate an experienced anesthesiologist.

Complications of surgery is extremely rare.

Bleeding - unexpanded problem is usually solved by creating pressure in the wound area. In extremely rare cases, you may need surgery to stop the bleeding.

Infection is also an infrequent complication, which eliminated the appointment of antibiotic therapy for one or two weeks.

Relapse after surgical treatment of hydrocele develops very rarely. Sometimes after surgery testes may be positioned slightly higher than before the operation. Consult your urologist if you noticed it.

Other extremely rare complications may develop during an operation in the case of damage to the structures of the spermatic cord, namely, the vas deferens or blood vessels supplying the testicle.

In the future, this may affect fertility (the possibility to conceive a child), especially if the second egg and compromised furthermore circulatory disorders can lead to unpleasant consequences up to necrosis (death) testicular tissue.

A source: https://03uro.ru/hydrocele/surgery_for_hydrocele_in_children

Hydrocele - hydrocele

Hydrocele represents the accumulation of fluid between the sheets of the tunica vaginalis testis or along the seminal cord (funikulotsele).

Hydrocele may be congenital or acquired, acute or chronic. Hydrocele occurs in about 10% of infants, and more than half of the edema disappears on its own in the first year of a child's life. This so-called physiological hydrocephalus.

The frequency of testicular dropsy

In 80 - 90% of newborn male celebrated cleft vaginal process of the peritoneum. By two years of cleft percentage decreases and already accounts for 25 - 40%. According to the autopsy 20% of men live their whole lives with cleft processus vaginalis of the peritoneum. However, the clinical manifestations of hydrocele observed in only 6% of newborn males.

The causes of hydrocele

Cleft vaginal process of the peritoneum. Normally, during embryonic development, testis, sinking of the abdomen into the scrotum, the passage captures through the inguinal canal with the peritoneum, which is the tunica vaginalis spermatic cord and testicle.

thereafter the process of peritoneum grows. This cleft in the scrotum continuously penetrates the liquid formed in the abdominal cavity.

In this case a so-called communicating hydrocephalus, since the horizontal position of the patient it may disappear, because the fluid falls back into the abdominal cavity.

This mechanism is identical for the occurrence of congenital hernias, since a rather wide lumen cleft sprouts peritoneum into the scrotum may fall and some organs (eg, strands gland, small intestine, or an egg from the scrotum to the inguinal channel).

Excess production of liquid egg shells. Acute inflammatory diseases of the testis and epididymis (orchitis and orchiepididymitis), trauma, tumors. Postoperative hydrocele. Often after surgery on the scrotum, as well as varicocele and inguinal hernia may also develop a hydrocele.

In adults, the cause of hydrocele can be filariasis, a parasitic disease caused by a parasite Wuchereria bancrofti.

The symptoms of hydrocele

Hydrocele usually detected patients randomly. In the scrotum noted painless swelling, the dimensions of which may vary considerably. Swelling this elastic to the touch, the skin color in the area normal.

When communicating hydrocele this swelling may disappear completely in the horizontal position of the patient. In the upright position of the patient, she does not appear immediately, but gradually. The general condition of the patient is not broken.

However, often it occurs discomfort in walking, physical exercise.

diagnosis of hydrocele

Diagnosis of hydrocele does not pose much difficulty. In this case, the doctor simply inspection and palpation of the dropsy. Sometimes, in order to clarify the nature of the "content" swelling conducted a method such as diafonoskopiya or Supersonic soundings diagnosis.

Transillumination is swelling candling lamp. In this case, if the scrotum contains serous fluid (which occurs usually during hydrocele), the light passing through the swelling is uniform.

If the basis is not swelling liquid, but, for example, organs (intestine, omentum strand, etc.), the light does not pass through swelling.

It must be said that the dropsy be differentiated (distinguished) from other diseases that may appear similar. For example, the inguinal-scrotal hernia. When this swelling may also disappear when the horizontal position of the patient and to reappear when upright.

However, your doctor may identify some differences, for example, can be determined at a palpation authorities not to pass light at diafonoskopii. Moreover, in the diagnosis of hydrocele and in order different from the inguinal-scrotal hernia applied a method such as ultrasonic diagnostics.

Ultrasound accurately determine the volume of liquid presence in the scrotum organs from the abdomen, as well as the structure of the testis.

Hydrocele confuse it with inflammation (orchitis or orchiepididymitis) difficult. The latter is manifested by sharp constant pain in the swelling, while there is soreness, redness and swelling of the local increase in temperature, which is dense to the touch. Furthermore, in the inflammation egg suffers and the overall condition of the patient may be fever, malaise.

Complications of hydrocele

• Discomfort and pains in the scrotum, especially during walking, physical exercise.
• Cosmetic defect.
• Joining the inflammatory process
• Trauma and the development of a hematoma (blood vessels rupture and accumulation of blood) of the scrotum
• Violation of the blood supply to the testis and spermatogenesis

Hydrocele operation - Operation Winckelmann - Operation Bergman - Operation Lord

Currently, there are several surgical treatments for dropsy of testicular membranes - Winckelmann, Bergman, Lord and puncture method. The essence of all surgical treatment methods is reduced to the elimination of a hydrocele. However, each method has its indications and contraindications, advantages and disadvantages.

Operation Winckelmann with hydrocele

The operation in children is performed under general anesthesia in adults - under local anesthesia. In the front region of the scrotum above the swelling is carried out skin incision length of 4 - 5 cm and then all the membrane to the tunica vaginalis. Egg in the vaginal membrane is displayed in the wound.

Next, puncture the tunica vaginalis is held by syringe and pumped liquid. Further, this shell is also dissected. After that examined egg and its appendage. Then, the plastic egg shells by Winckelmann.

It lies in the fact that the shells are turned out like "inside out" and stapled.

Thus the liquid produced by the tunica vaginalis testis epithelium will be sucked surrounding tissues. When communicating hydrocele addition sutured clearance processus vaginalis. Next, the skin is sutured nodal catgut sutures. The wound left a small rubber drain.

This is necessary milking preventing accumulation in the blood and scrotum hematoma formation. Immediately after surgery the wound superimposed bubble with ice for two hours. The sutures dissolve on their own within 10 days.

After surgery, Winkelman, as with varicocele scrotum superimposed suspensory - suspensory bandage.

Operation Bergman at hydrocele

This operation is carried out at a hydrocele large thickening membranes.

Technique is similar to the above-described first. On the front surface swelling scrotal incision length is 5 - 6 cm. layers are dissected shell eggs. Next to the tunica vaginalis testis is displayed in the wound. As the liquid is pumped via a syringe. After that dissected tunica vaginalis testis and it is excised around the testicle.

On residues tunica vaginalis superimposed catgut sutures. Further egg plunges back into the scrotum. Ketoguovymi sutured skin sutures. The wound left a small rubber drain. Immediately after surgery the wound superimposed bubble with ice for two hours. The sutures dissolve on their own within 10 days.

Superimposed on the scrotum jockstrap.

During these traditional surgery for hydrocele to expose dropsical cysts bag or carry as Typically, an extended section of the scrotum, the release dropsical bag from the surrounding tissue and complete removal of the testicle in wound.

As a result, the shell scrotum injured, broken vessels, which are reduced, making it difficult to stop the bleeding and leads to the formation of haematomas.

In addition, excessive traction testicle during an operation to provoke breach of blood and lymph circulation, which often contributes to the development of postoperative orchitis.

Operation Lord with hydrocele

Lord operation technique involves cutting and corrugating dropsical bag around the tunica vaginalis testis, which is not released from the surrounding tissues and dislocating the wound. Due to the minimized trauma surrounding tissue and vascular supply.

Puncture method when hydrocele

Puncture method is one of the easiest, and is conducted that hydrocele puncture needle and the pumped liquid. Unfortunately, the results of this treatment are short and always relapse dropsy.

Operation when communicating hydrocele in children. Ross operation

In communicating hydrocephalus, is typically used the Ross procedure - selection of the elements of the spermatic cord, excision and ligation of the internal inguinal ring in peritoneal process, as well as the formation of a "window" in the envelopes testicle. The operation is performed from a small incision in the groin.

Delicate operation that requires good technique - tidy and careful dissection with preservation of all anatomic structures of the spermatic cord - the vas deferens and testicular vessels and inguinal nerve.

Sometimes used laparoscopic surgery for hydrocele, but the trauma, the risk of recurrence and complications when used above and anesthesia duration longer, so they are not widespread find.

Operations in isolated hydrocele and lymphocele in children and adolescents.

Insulated edema and lymphocele are indications for surgery Bergman - excision of the inner shells of the eggs scrotal access. In cases of hydrocele volume and lymphocele often left in the wound drainage and compression bandage is applied.

A source: https://medmente.ru/articles/vodyanka-yaichka-gidrocele.html