Testis & Urethra Hydroele

A hydrocele can result through either increased production or decreased resorbtion of fluid, in most cases it is usually idiopathic.

*     Hydrocele is also frequently secondary to results of Epididymoorchitis or trauma.

      The other differentiating features are depicted in  This swelling of scrotum results from excess fluid accumulating in the two layers of tunica vaginatis. The fluid is straw coloured. It contains water, proteins, electrocytes and cholesterol.

CONGENITAL HYDROCELE

      The tunica vaginatis communicates at the inguinal canal with the peritoneal cavity and contains fluid. It may reduce on lying down and pressure applied to the scrotum.

INFANTILE HYDROCELE

      This is a fluid filled sac that can be felt upto the inguinal region but does not communicate with the pertoneal cavity. It is not reducable

6.1 Treatment

      Aspiration is the simplest treatment and allows palpation of testis. It refills and is thus a incomplete treatment

6.2 Jaboulays Operation

      The sac is dissected free of the skin and dartos incised fluid drained. The redundant sac excised and the cut margin sutured. Haematoma can occur if haemostatis is less than prefect.

Lord’s Operation

      The sac is opened and drained through a renal incision and the sac is plicated Fig 27.7.

Fig 27.7

HYDROCELECTOMY (JOUBLEY'S)

OBJECTIVE

In cases of:

-        Hydrocle

-        Excision of a portion of the tunica vaginatis testis with evacuation of fluid contained

STEPS

-        A scrotal approach is employed

-        The hydrocele fluid is aspirated through a small incision or with a needle and syringe

-        Excessive sac wall is excised or may be wrapped around and sutured behind the epididymis

-        If a hernia is present it is repaired

-        The incision is closed

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