Treatment of dropsy of the testicles in boys and adolescents

Dropsy of the testicles is a common condition most commonly seen in newborn boys and mature men. It is characterized by the accumulation of pathological exudate, leading to an increase in the size of the affected organs. In the absence of timely treatment, dropsy of the testicle in a child can lead to serious complications, including infertility.

Most often, the disease manifests itself in newborns, but later development is possible. As a rule, pathology is present only on one side, for example, in the right testicle.

The reasons for the development of the disease

Hydrocele (another name for dropsy) is of two main types - congenital and acquired. The first appears if the child has a failure in the development of the testicles.

This violation is associated with the period when the organ descends to the inguinal canal. Situations are possible in which complete overgrowth of the process does not occur, as a result of which the shell becomes a place of accumulation of pathological fluid. Although the disease in children is quite severe, it often goes away on its own, so there is no need for surgery.

However, it is necessary to know the reasons why dropsy started at all. As a rule, this can lead to:

• Mother's unhealthy lifestyle. Excessive alcohol consumption, smoking and other bad habits can be the causes of diseases in babies, and far from only one dropsy;
• A number of medications. Not all medicines are safe for mothers and babies during pregnancy. Many of them are capable of damaging internal organs;
• Diseases transferred during gestation are also possible causes of dropsy of the testicles. For example, rubella can end with this. Often, women who have had such a disease are recommended to terminate the pregnancy;
• Finally, there can always be a factor of heredity. Dropsy of the testicles in boys can be transmitted from generation to generation.

The second type of pathology differs in many respects from the first. What is an acquired type of dropsy is easy to guess by its name. The disease develops over time, due to various injuries or inflammations. As a rule, the following reasons for the appearance of pathology are distinguished:

• Inflammatory processes in the testicles;
• Orchitis disease;
• Neoplasms in the reproductive system;
• Focuses of inflammation in the appendages;
• Serious injury and damage.

Finally, there are two other possible reasons to keep in mind. Treatment of dropsy of the testicles in boys is often associated with effects on the cardiovascular system and blood circulation. The fact is that the accumulation of effusion can occur due to blood clots in the vessels. In addition, a huge number of cases are associated with postponed operations. As a result of surgical interventions, dropsy of the testicles in a child develops as a complication.

Features of the development of dropsy in boys over a year old

There are a number of other cases that can lead to the manifestation of the disease in children aged 1-5 years. For example, up to three years of age, dropsy of the testicle in a child can cause the consequences of pregnancy. These include injuries sustained during childbirth, prematurity and cases when there was high pressure in the womb due to wall defects.

Congenital anomalies such as cryptorchidism, as well as a malformation of the male genitourinary system, also have their effect. Finally, pregnancy-related ascites and ventriculoatrial shunting are also potential causes.

If dropsy of the testicular membranes begins in a boy from the age of three years, then most often it is secondary. In this case, the reactive type is distinguished, associated with problems in filtration and re-suction of liquids from the shell. This usually happens for one of the following reasons:

• Testicular torsion;
• Mechanical impact on the scrotum area;
• Orchitis and other inflammatory processes
• Neoplasms in this area.

Occasionally, there are situations when dropsy of the testicles in boys appears against the background of colds, such as acute respiratory viral infections and flu, as well as infections, such as mumps. Finally, if the child has had hernia surgery or varicocelethen fluid accumulation is also possible.

In young children, the disease can be acute or chronic. The first option is more common in older boys, especially after suffering viral and infectious diseases, including mumps. In this case, the pathology develops rapidly and strongly.

Chronic type is the result of the lack of timely treatment of acute.

Key symptoms

In order for dropsy of the testicular membranes to be completely cured, you need to know what it looks like. This will allow you to notice the onset of the disease in time and consult the appropriate doctor.

The main symptom of any type of dropsy will be an enlargement of the scrotum in size. This can be seen only from one or all sides. Communicating dropsy of the testicle in children is transient. The degree of increase and tension can change several times a day. The communicating type is most pronounced during the daytime, and at night, with a minimum amount of movement, the swelling can practically disappear, as the effusion passes back into the abdominal cavity.

In the isolated type, growth occurs gradually and, depending on the severity of the case, the final size may be similar to a goose egg or the head of a child. In any case, the baby almost never experiences pain, and there are no signs of inflammation in the body.

Pain syndrome, as a rule, appears if a child has dropsy of the testicle for the second time, against the background of the absence of primary treatment. This disease can be accompanied by redness, fever and vomiting. Finally, a particularly strong accumulation of exudate leads to problems with urination and discomfort when walking.

In some cases, the pathology may be accompanied by trembling and a feeling of general weakness. Regardless of the number of symptoms, it is necessary to see a doctor as soon as possible, since home treatment is unable to give a positive result.

Diagnostics and treatment

To treat dropsy in babies, you need to contact a pediatric surgeon or urologist. The doctor will examine the patient and palpate his scrotum while lying and standing. This will help determine the type of disease.

After that, you need to do a diaphanoscopy, which detects fluid, oil seals and other elements that indicate a possible hernia. Finally, an ultrasound scan gives an accurate diagnosis, simultaneously excluding cancer and injuries.

Sometimes doctors prefer to do other tests, such as ultrasound, and they also carry out differential diagnostics, which allows them not to consider the possibility of spermatocele and cysts.

The doctor then decides how to treat the disease. Very few cases require immediate intervention: as a rule, the specialist resorts to expectant tactics. He observes the course and development of pathology, as it often goes away on its own.

If the case is serious, then the liquid is removed from the shells. This often has to be repeated several times. Full-fledged operations are performed at the age of one to two years. If the disease was caused by trauma, then surgical intervention is possible about three months after that.

Of course, it is better to prevent the appearance of pathology than to cure it. Mothers should take care of this - their healthy lifestyle and monitoring the condition of the child will help to avoid various dangers.

Development mechanism

The testicles in the fetus are located in the abdominal cavity and descend into the scrotum at about the seventh month of development, while carrying with it a part of the thin film of connective tissue, the peritoneum, which lines the cavity in the tummy from the inside child. This forms 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 is isolated or communicating.

With communicating dropsy, peritoneal fluid enters the pocket through the vaginal process, which connects the abdominal cavity and the scrotum. In most cases, this process can close on its own by one and a half years, but nevertheless, the disease should not be allowed to take its course.

With an isolated hydrocele, fluid is produced by the testicular sheath. 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 disturbed, fluid begins to accumulate, and dropsy of the testicle occurs.

Causes of the appearance of dropsy of the testicles

Conditionally, the reasons for the development of hydrocele can be divided into two large groups: congenital and acquired.

Congenital dropsy is considered a minor malformation and has nothing to do with gene mutation. It is characterized by a mechanism of development of the communicating type. Non-clotting of the processus vaginalis (embryonic disorder) occurs for many reasons:

• pathological course of pregnancy: the threat of miscarriage, infectious and chronic diseases of the mother, intrauterine infection;
• getting a birth injury;
• cryptorchidism (undescended testicle into the scrotum);
• prematurity;
• hypospadias (an anomaly in the 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:

• defects of the abdominal wall;
• ascites (accumulation of fluid in the abdominal cavity);
• ventriculoperitoneal shunts (a device for draining excess fluid into the abdominal cavity);
• peritoneal dialysis (a procedure for artificial blood purification using the filtration properties of the peritoneum).

Secondary dropsy of the testicles, or reactive hydrocele, which in most cases is characterized by a non-communicating developmental mechanism, can occur in the following cases:

• trauma to the scrotum;
• torsion of the testicle;
• various inflammatory diseases of the testicle and its appendages (orchitis, epididymitis, etc.);
• phillariosis (damage to the lymph nodes caused by helminths) and other diseases leading to damage to the lymphatic system;
• swelling of the testicle and its appendages;
• complication of infectious diseases (ARVI, influenza), including children (for example, mumps);
• complication after surgery - hernia repair, varicocelectomy (removal of dilated testicular veins and spermatic cord) - due to damage to the structure of the spermatic cord, in particular, the lymphatic vessels, while the absorption of the fluid produced by the vaginal shell;
• severe cardiovascular failure.

Hydrocele classification

Dropsy of the testicles was classified in several directions at once.

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 by an inguinal hernia, and this is an indication for surgery;
• non-communicating hydrocele (isolated), which looks like a cyst, while the processus vaginalis is blind; this option is treated only promptly.

Depending on the pressure of the fluid in the scrotum:

• tense dropsy: the fluid is under pressure (in most cases this is a non-communicating variant of a hydrocele, moreover, requiring urgent surgery);
• relaxed dropsy (most often this is a communicative type).

Depending on the course of the process:

• acute (usually a consequence of inflammation, injury or tumor);
• chronic (recurrent).

Without the necessary treatment, an acute process can easily become chronic.

Localization distinguishes:

• 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 the age of three.

Symptoms of dropsy of the testicles

Most often, parents reveal dropsy during hygiene measures. The surgeon can also detect the disease during a preventive examination of the baby. The child himself is most often not worried about this condition, there is no pain or discomfort.

The most common symptoms of a hydrocele are an enlargement of the scrotum on one or both sides in size and the cyanosis of its skin. Swelling in the groin area may indicate a hernia or other associated pathological conditions.

With trauma, soreness of the scrotum appears, and with secondary infection of the dropsy of the testicle, more serious symptoms occur:

• crying and anxiety of the baby when touching the scrotum;
• fever and symptoms of general malaise;
• chills;
• redness of the skin at the site of the lesion;
• nausea, vomiting;
• Difficulty urinating, possible acute urinary retention;
• unpleasant bursting sensations in the groin area, discomfort when walking, which older children complain about.

The communicating hydrocele can change in size and tension during the day, while the isolated dropsy grows gradually.

It is especially dangerous when the disease occurs during adolescence. Boys are often embarrassed to tell their parents about their problems and bring the disease to the development of complications.

Diagnostics

The doctor will notice the problem when examining the child's genitals.

Diagnosis of a hydrocele is not particularly difficult and consists of several successive stages:

• collection of typical complaints from parents or a child;
• 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 dropsy of the testicle is, 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, as this increases intra-abdominal pressure.

• Palpation (probing) of the scrotum, which reveals an elastic seal in the form of a pear, with the upper end facing the inguinal canal;
• diaphanoscopy (transillumination): shining a flashlight through the scrotum.

The fluid always transmits light well, while the tumor or omentum, as well as part of the intestine with an inguinal-scrotal hernia, will hold it back.

• 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 the amount of fluid, as well as to exclude more serious pathology, for example, inflammation, torsion of the testicle and its appendages;
• Doppler ultrasonography of the scrotum vessels is an additional examination method that will help to finally make a diagnosis;
• blood and urine tests will show the general condition of the body and facilitate differential diagnosis with other pathologies of the scrotum and testicle, as well as with their complications.

Treatment of dropsy of the testicle

The method of treating a hydrocele directly depends on the type and causes of the pathology.

Physiological dropsy is easy enough to observe. This is a wait-and-see tactic, since in babies under one year old, the hydrocele may well go away on its own. At the same time, the only thing that is required of parents is the prevention of colds and digestive disorders, since sneezing, coughing and vomiting cause a sharp jump in intra-abdominal pressure. This, in turn, promotes the flow of fluid into the scrotum.

With acquired hydrocele, first of all, treatment of the underlying disease that caused the pathology should be carried out.

So, with post-traumatic dropsy of the testicle, nonsteroidal anti-inflammatory drugs (Dolaren, Fanigan, Ibuprofen, Movalis, Paracetamol, Diclofenac, Nurofen, etc.), and in case of an infectious disease, antiviral or antibiotics (Augmentin, Flemoxin, Tsiprinol, Abaktal, etc.).

Operative treatment

With isolated dropsy, a Winckelmann, Lord or Bergman operation (if the child is over 12 years old) is performed, as well as a puncture. An incision is made on the scrotum at the site of the dropsy projection, the testicle is brought out through the wound, the fluid is sucked out and the vaginal membrane is dissected.

In Winckelmann's operation, this shell is turned inside out and sutured. Then all the fluid produced will be absorbed by the surrounding tissues. Then everything is sutured in layers, a small rubber drainage remains in the wound for the outflow of blood.

During Bergman's operation, which is performed for large hydrocele and thick membranes, the vaginal process is simply excised at its very base, and the remnants are sheathed with special sutures. After that, the testicle is immersed back into the scrotum, and everything is sutured in layers, and a small drainage remains 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 vessels surrounding the testicle are not injured. The vaginal membrane itself is simply corrugated and sutured.

The communicating dropsy is treated with the Ross operation, in which the vaginal process is carefully ligated in the area of ​​the inner inguinal ring and cut off. Then a hole is formed in the vaginal membrane for the outflow of fluid from the scrotum.

The operation of post-traumatic dropsy is indicated after 3-6 months from the moment of injury, and until this moment, only observation is necessary. At this time, a reduction (decrease in size) of the hydrocele sometimes occurs.

Indications for surgery up to two years of age:

• the presence of an inguinal hernia and the risk of its infringement;
• persistent discomfort in the groin area;
• a rapid and intense increase in the size of the scrotum, especially with a tense hydrocele;
• infection of the dropsy of the testicle.

Intense dropsy can only be treated with surgery. 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 reappear.

Features of preparation and the course of the operation

Surgical treatment of congenital hydrocele is carried out in 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 a cold and other diseases, it must take some time (but not less than a month) for the body to get stronger. Before the operation, you need to pass a general blood and urine test, and six hours before the operation, the little patient cannot eat or drink anything.

The operation is not technically difficult. It is carried out under general anesthesia (although the intervention under local anesthesia is easier for the doctor to control), while an additional injection of anesthetic drugs into the vein is possible. During the operation, breathing and heartbeat are necessarily 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 hanging bandage, a pendant.

In a few hours, the child will be allowed to go home with his mother. In the evening, the baby can drink, and a little later and eat.

Thanks to general anesthesia, the child will not have psycho-emotional stress at the sight of tools, strangers in white coats and strange smells. Also, there will 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.

After each diaper change, it is recommended to treat the seam with an antiseptic (Chlorhexidine, Betadine, etc.).

If the wound has stitches made of non-absorbable material, then a week later you need to go to the doctor and remove them.

The child should go through the next examination by a doctor in a month.

After the operation, you cannot:

• engage in active games, the child only needs peace;
• touching the wound so as not to cause bleeding or infection;
• wet the wound before removing the stitches; however, the child can wash gently.

To avoid postoperative complications, the mother must strictly follow all the surgeon's recommendations.

Possible complications after surgery:

• complications after anesthesia are 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 occurrence that can be eliminated by pressure in the wound area, and only as a last resort you have to resort to surgical intervention;
• relapse of dropsy can occur only if the testicle is 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 any pathological process;
• testicular atrophy in violation 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 lifted up.

Puncture method of treatment

The easiest method of treatment. It consists in puncture of dropsy and pumping out fluid from it. The effect of treatment is very short-lived and always leads to relapse of the disease.

Sclerotherapy

A fairly new method of treatment, in which relapses of the disease do not exceed the threshold of 1%. The essence of this method is to remove fluid from the membranes and inject sclerosing drugs, such as Betadine or alcohol, in its place. They cause non-infectious (aseptic) inflammation of tissues with their subsequent fusion, which leads to the complete disappearance of the cavity where the fluid accumulated.

Complications of dropsy

With untimely treatment started and a chronically proceeding process, complications very often develop:

• a significant increase in the size of the scrotum, while the size of the testicle decreases;
• the addition of a secondary infection and the development of the inflammatory process;
• infringement or compression of a hernia;
• circulatory disorders with subsequent testicular atrophy;
• violation of spermatogenesis and male infertility.

Forecast

Congenital dropsy often resolves on its own.

Surgical competently performed operation helps to get rid of pathology forever and avoid complications.

In most cases, with timely treatment started, the prognosis is favorable. In this case, the hydrocele will not in any way affect the reproductive functions in the future.

Prophylaxis

Preventive measures are to prevent inflammatory diseases and injuries of the genitourinary system. A regular examination by the parents of the baby's genitals is required. And with adolescents, it would be appropriate to have a delicate conversation about this disease in order to avoid numerous, often irreversible complications.

Which doctor to contact

Usually, dropsy of the testicle is found during a routine examination by a urologist or surgeon. The urologist, together with the pediatrician, is observing such a child even in the case of conservative treatment. In some cases, consultation with an infectious disease specialist is recommended.

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Causes of dropsy of the testicle in boys

Congenital dropsy on the testicles in boys is a consequence of intrauterine malformations. Normally, at 28 weeks in the fetus, the testicle descends along the inguinal canal into the scrotum.

Together with it, the vaginal process of the peritoneum moves there. After the proximal part of the peritoneal process is overgrown, the vaginal membrane of the testicle is formed from the distal part.

If, before the baby is born, the processus vaginalis of the peritoneum does not overgrow, a small communication between the abdominal cavity and the scrotum remains. Through it, peritoneal fluid enters the scrotal cavity and accumulates there. In addition, the inner lining of the peritoneum can independently produce fluid. In most cases, the process is overgrown by one and a half years.

The reasons for the non-closure of the vaginal process and the formation of a hydrocele in boys under the age of three lie in:

• the resulting birth injury;
• pathological course of pregnancy;
• hypospadias (underdevelopment of the genital organ);
• prematurity;
• cryptorchidism (undescended testicle into the scrotum);
• ascites (abdominal dropsy);
• defects of the abdominal wall, etc.

In children over the age of three years, dropsy of the testicles is caused by a violation of the processes of reabsorption and filtration of the fluid secreted by the vaginal membrane of the testicle. The problem is caused by:

• scrotal injury;
• torsion of the testicle;
• testicular / epididymis tumor;
• inflammatory diseases (epididymitis, orchitis, etc.).

Sometimes hydrocele is a complication of influenza, SARS, mumps, and some other infections. It can also be the result of hernia repair.

Symptoms of dropsy of the testicles in boys

Most often, parents discover hydrocele on their own when they carry out hygiene procedures. A pediatric surgeon can also diagnose it during a routine check-up. The main symptom of dropsy of the testicle in boys is an enlargement of the scrotum in size from one or both sides at once. If the hydrocele is of a communicating form, the increase is transient; if it is isolated, it occurs at a slow pace, gradually. The size of the scrotum in a small patient can be different - from a goose egg to a baby's head. It all depends on the neglect of the disease.

With communicating dropsy, the swelling increases during the day and decreases / disappears completely at night. There are no other characteristic symptoms of uncomplicated pathology. The child feels well, no pronounced inflammatory process is observed.

In a situation of secondary infection, dropsy of the testicle appear:

• chills;
• soreness and redness of the scrotum;
• vomit;
• temperature.

If the volume of accumulated fluid is very large, urination becomes difficult, and acute urinary retention occurs. The child complains of discomfort while walking, a feeling of fullness in the groin.

If you find yourself with similar symptoms, see your doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnosis of dropsy of the testicle

During the consultation, the pediatric urologist examines and palpates the enlarged scrotum. To find out the shape of the hydrocele (communicating or non-communicating), the child is first examined in a standing position, and then in a prone position. If the size of the dropsy decreases when the child lies, we can talk about the presence of a message of the dropsy with the abdominal cavity. An increase in the scrotum when the child coughs also speaks in favor of this form of the disease.

Among the diagnostic techniques:

• Diaphanoscopy. The tissues are examined in transmitted light. As a result of the procedure, not only liquid can be found in the scrotum (it evenly transmits the light flux), but also a part of the intestine, an omentum (they trap the light). They talk about the development of an inguinal-scrotal hernia.
• Ultrasound of the scrotum and inguinal canals. It makes it possible to exclude torsion of the testicle or its epididymis, testicular cancer, and also to determine the type of hydrocele.

Treatment of dropsy of the testicles in boys

Children with congenital dropsy of the testicle under the age of one year are registered with a pediatric urologist and surgeon. Since in most cases, such a hydrocele resolves on its own, doctors take a wait-and-see attitude.

If dropsy is a consequence of other diseases, maximum attention is paid to the treatment of the latter. With a tense form, a puncture is performed, the liquid is removed from the testicular membranes. But this method of treatment has a significant drawback - the likelihood of re-accumulation of fluid is quite high. This means that repeated punctures may be required.

Surgery

Treatment of independently not passed congenital dropsy of the testicle in boys is surgically performed at the age of one and a half to two years. If the pathology is the result of trauma to the scrotum, they wait up to six months from the moment the first symptoms of the disease appear. The indications for surgery are also:

• simultaneous diagnosis of hydrocele and inguinal hernia in patients over two years old;
• accession of a secondary infection;
• rapid progression of the inflammatory process.

With non-communicating dropsy, operations can be performed:

• Winckelmann. Consists of eversion and stitching of the testicular sheath behind it under general anesthesia. The testicle is taken into the wound from its membranes, the serous fluid is aspirated with a syringe, the membrane is dissected, inverted and sutured around the testicle. The testicle is immersed in the scrotum. The wound is sutured.
• Lord. The water sac is dissected and the vaginal membrane around the testicle is corrugated.

  The latter is not released from the surrounding tissues and is not dislocated into the wound, therefore, trauma to the supplying vessels and adjacent tissues is minimized.

• Bergman. It is carried out if the dropsy is large, the testicular membranes are thickened. An incision is made on the anterior surface of the scrotum, the testicular membranes are dissected in layers. The testicle, together with the vaginal membrane, is brought out. Serous fluid is pumped out with a syringe. The testicular sheath is then dissected, after which it is excised around the testicle. The remaining membrane is sutured, the testicle is immersed in the scrotum.
• Ross. Performed if the hydrocele communicates with the abdominal cavity. The peritoneal process is ligated, the pathways for the outflow of aqueous fluid are formed.

Danger of disease

In 80% of cases, physiological dropsy of the testicle in boys goes away on its own during the first year of life. If surgical treatment is necessary, doctors manage to avoid complications - the problem disappears and does not return.

A health hazard is chronic hydrocele, which can cause future spermatogenesis disorders and infertility. Also, the disease can provoke a violation of sensitivity in the testicle and its atrophy.

Prevention of dropsy of the testicles in boys

Prevention of hydrocele in childhood consists in the prevention of inflammatory diseases and injuries to the scrotum. Parents need to regularly examine the boy's genitals and, if swelling is found, immediately consult a doctor.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

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Why does this happen and what happens?

Testicular dropsy can be congenital or acquired.

Until the early 20th century, the most common cause of acquired testicular dropsy was gonorrhea. Nowadays, hydrocele often manifests itself after injuries, but usually so minor that a person does not pay attention to them. 2-3 weeks after such an injury, a painless swelling develops in one of the halves of the scrotum, which slowly increases. The process can go on for several years, without pain and any disorders - such a dropsy of the testicle is called chronic. Only when the hydrocele is large (up to the size of the child's head) do difficulties with urination and sexual dysfunctions appear.

Dropsy of the testicle can manifest itself as a complication, for example, after kidney transplant surgery or varicocele treatment.

Acute (reactive) dropsy of the testicle often manifests itself against the background of another, more serious disease: inflammation of the epididymis (epididymitis).

Diagnostics and treatment

Dropsy of the testicular membranes does not cause difficulties either in diagnosis or in treatment. When determining this disease, the andrologist conducts an initial examination of the man's genitals. The most informative in the diagnosis of hydrocele is an ultrasound examination of organs scrotum, which allows you to measure the volume of watery fluid, as well as assess the condition of the testicle and its appendage.

In cases where the hydrocele is a consequence of the development of other diseases (inflammation, gonorrhea, etc.), it is necessary to first treat these particular ailments.

For all other types of dropsy of the testicle, the method of treatment is surgical. The only exception: the operation is not performed for children under 1-1.5 years old with congenital dropsy.

By itself, a small accumulation of fluid does not cause any complications. However, the watery cavity can become large, making physical activity and sex life difficult. In addition, with untimely treatment of dropsy and its large volumes, testicular atrophy and irreversible disruption of sperm production are possible, which leads to male infertility.

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Causes of occurrence

• Inflammatory diseases of the epididymis;
• Testicular injury;
• Non-closure of the peritoneum after the descent of the testicle into the scrotum;

Clinical manifestations of hydrocele

According to the clinical course, there are 2 forms of hydrocele - acute and chronic. The manifestations of a hydrocele are:

• The swelling of the scrotum is round or pear-shaped;
• Absence of pain syndrome;
• Discomfort in the scrotum when walking;

Diagnosis of a hydrocele usually does not cause difficulties; dropsy of the testicular membranes must be distinguished from inguinal and inguinal-scrotal hernia, testicular tumor. In order to clarify the diagnosis, ultrasound of the scrotum is performed, which has the highest reliability in the diagnosis of hydrocele. In the clinics of the Mother and Child Group of Companies, when contacting a urologist, according to the results of the examination, the optimal treatment option for hydrocele will be proposed.

Hydrocele treatment

Reactive or symptomatic dropsy of the testicle, resulting from inflammation of the testicle (orchitis) or epididymis (epididymitis), is not requires surgical intervention, treatment consists in the appointment of complex therapy aimed at eliminating the inflammatory process.

In case of primary hydrocele, it is recommended to carry out a surgical intervention aimed at emptying the contents of the hydrocele and performing plastic surgery of the testicle's own membrane to exclude recurrence diseases.

Urology doctors at the Mother and Child Clinics are equipped with all the necessary equipment to diagnose and eliminate hydrocele in the shortest possible time. Hospitalization for surgical correction of a hydrocele will take less than a day.

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