hydrocele

Hydrocele: description

As hydrocele medics denote an accumulation of water in the testes, in the spermatic cord or in the epididymis. She is either innate or acquired. It is most common in boys born prematurely. About six percent of all mature newborn boys have hydrocele (hydrocele, hydrocele testis).

Hydrozeles: Various diseases

As a rule, the fluid is located between two skins that surround the testicles (collectively called tunica vaginalis testis). If fluid accumulates in the spermatic cord, it is called a hydrocele funiculi spermatici. An accumulation of fluid in the epididymis is called spermatocele.

When a fluid in the groin occurs in girls, it is called a Nuck cyst. This disease is rare.

Hydrocele: symptoms

A hydrocele is characterized by a one-sided or bilateral swelling of the scrotum. It usually develops slowly and is not painful. She feels bulging-elastic. If the water break is very large, it can restrict the mobility of the patient, such as walking.

A congenital testcene usually fills up standing, because the fluid from the abdominal cavity follows gravity. As she lies down, she empties herself again.

Should it bleed into a hydrocele, such as by force or by a disturbed blood coagulation, doctors speak of a hemocele.

Hydrocele: causes and risk factors

A hydrocele can be either innate or acquired. Depending on the form of the hydrocele, there are corresponding causes and risk factors.

Hydrocele: Congenital water break

If the hydrocele is innate, doctors also speak of a primary hydrocele. So this form of water break affects baby and toddler. Only rarely does a congenital hydrocele occur in older children.

Preterm babies in particular have an increased risk of a primary hydrocele. The reason lies in the development of the testicle: While the child grows up in the mother’s abdomen, the testicle forms in the abdominal cavity, enveloped by the peritoneum lining the abdominal cavity. In the course of pregnancy, it descends through the inguinal canal into the scrotum, forming an outgrowth of the peritoneum (“processus vaginalis peritonei”). It usually closes during pregnancy. If this does not happen, fluid from the abdominal cavity can enter the scrotum, creating a hydrocele.

Hydrocele: Acquired water break

An acquired hydrocele is also called a secondary hydrocele. It can have different causes like:

• Inflammation of testicles or epididymis
• Acts of violence (blows, kicks)
• Testicular Twist (Testicular Twist)
• Inguinal hernia
• Tumor (tumor)

Hydrocele: examinations and diagnosis

A hydrocele, when it is innate, is first treated by the pediatrician. The specialist for the treatment of hydrocele is the urologist or a surgeon. To diagnose a hydrocele, your doctor will first ask you in detail about the history of the disease (anamnesis). He will ask you the following questions:

• Is your child born too soon?
• When did you first notice the swelling of the testicle?
• Does the swelling change when standing or lying down?
• Was there any violence on the testicles?

Hydrocele: physical examination

This is followed by the physical examination. The doctor scans the swelling on the scrotum and makes sure that it is plump-elastic or whether any hardening can be felt. He then illuminates the scrotum with a flashlight. If there is a hydrocele, the light shines through the fluid.

Furthermore, an ultrasound examination (sonography) of the testicle is usually made. In this case, the fluid accumulation can also be displayed. This is also possible with magnetic resonance imaging (MRI). However, it is more expensive than an ultrasound examination.

Hydrozele: differentiation against other diseases

From a possible water break the doctor must differentiate other diseases. Similar symptoms can occur, for example:

• hernia
• Varicocele (testicular vein)
• tumor

If the examination does not allow a clear diagnosis, the testicle is exposed in an operation. This ensures that potentially serious diseases of the testicle are not overlooked.

Hydrocele: treatment

If there is an inborn hydrocele testis, no treatment is initiated initially. Instead, the water break is observed until the end of the second year of life. In most cases, it returns on its own, because the connection between the abdominal cavity and the testicles closes over time.

If this is not the case or the hydrocele is very large, surgery is performed. In the water-break surgery, a small incision is usually made in the groin and the location of the open connection is visited. This is closed by the surgeon afterwards.

If the patient suffers from a secondary (acquired) testicular hydrocele, it is often operated on immediately. This hydrozele surgery is usually done via a skin incision in the scrotum (scrotum), through which the liquid is removed.

Hydrocele: Outdated treatment options

Previously, a hydrocele testis was punctured with a needle or syringe to release the fluid. Nowadays, this is no longer done because of an increased risk of infection. Even a so-called sclerotherapy (“hardening”) with chemical substances is no longer performed. Because it causes increased peritonitis, and there is a higher risk that the hydrocele returns (recurrence).

Hydrocele: Disease course and prognosis

The prognosis of a hydrocele is good. The causal connection between the abdominal cavity and the testicles usually closes on the baby between the third and fourth month of life. In addition, until about the beginning of the third year of age, a closure can take place. Therefore, the therapy of a congenital hydrocele usually begins only with the completed second year of life.

The surgical therapy has a high healing rate, but the water break can recur (recurrence). In addition, bruising or infection may occur during surgery.

Hydrocele: possible complications

If the water break is not operated, complications can occur. These include:

• Indirect inguinal hernia: A bowel loop can pass through the inguinal canal and also be trapped.
• Inability to procreate: A large accumulation of fluid in the scrotum can squeeze the circulation of the testicle.
• Testicular torsion: The risk that the testicle turns around itself and thus disturbs the blood circulation is at one hydrocele elevated.