Scrotal hydrops (hydrocele)
Summary/Definition
Testicular dropsy is a disease in which serous fluid flows from the testicle or abdominal cavity into a space called the testicular capsule, also known as water cysts. Structurally, there is a pouch between the scrotum and the testicles, called the testicle shell, it appears when the space inside this shell is filled with a large amount of water. Hydrocele, which occurs in children, is an anomaly of the testicular membrane caused by biological disorders, after lowering the testicles, the hole in the abdominal wall closes. This is the most common scrotal disease, usually occurring on one side. It can occur in both adults and children, but since the causes of hydrocele in the scrotum area in adults and children are different, they need to be classified accordingly.
Dropsy of the testicle as a whole is divided into non-communicating and communicating dropsy. Non-communicating dropsy of the testicle occurs due to the accumulation of fluid in the scrotum. It occurs mainly in adults for no particular reason, but can also occur in cases such as orchitis, epididymitis, trauma, tumor, peritoneal dialysis and cirrhosis of the liver. Communicating scrotal dropsy occurs when a passage called the vaginal process (processus vaginalis) connects the scrotum and the inside of the abdomen. It occurs for congenital reasons, therefore it occurs in children and rarely in adults.
Symptoms
In most cases, testicular dropsy has no symptoms, but the scrotum may swell or hurt. In adults, the scrotum remains edematous or gradually increases. In severe cases, the scrotum can be so hard that it feels like there is an egg inside. In children, the size of the scrotum may increase and then decrease again depending on crying or activity. This is a characteristic feature of communicating dropsy of the testicle, since fluid can pass through open passages.
Diagnostics
The diagnosis can be made by collecting anamnesis, physical examination, transilluminational examination and ultrasound examination.
By collecting anamnesis, we determine whether the scrotum is swollen, whether it is painful, whether its size changes or whether there are no concomitant diseases. By means of a physical examination, it is possible to determine the degree and shape of the tumor, as well as whether it causes pain when touched, and it is also possible to perform transillumination, which is a method in which a small flashlight is pressed against the scrotum to observe how light passes through it. The fluid in the scrotum looks transparent. Ultrasound is the most accurate method of examination and allows you to distinguish hernias, tumors and inflammation, as well as confirm their presence or absence.
Treatment and course of the disease
Dropsy of the testicle in adults gradually increases or retains its size and does not disappear naturally, but does not affect health, even if it is not treated. Dropsy of the scrotum in children may or may not change in size and often disappears immediately after birth or within 1-2 years. In general, there are no health problems, but in some cases a hernia may occur – a disease associated with the protrusion of abdominal organs in the groin area, so caution is necessary.
Surgical intervention is the standard method of treating scrotal dropsy in adults and children. With dropsy of the scrotum in children, the process of the testicle is removed and blocked, which is a passage connecting the scrotum and the abdominal cavity.
Non-drug treatment includes paracentesis, which is a method of removing accumulated water by simply inserting a syringe into the scrotum. However, it can cause complications such as hematoma and orchitis due to bleeding or infection, so the hydrocele of the scrotum is so dangerous that it causes severe pressure or disrupts blood circulation. Such treatment will be applied temporarily.
Complications
In the case of dropsy of the scrotum in adults, complications, in addition to weight and pressure felt due to an increase in size, rarely occur, whereas in children, due to dropsy of the scrotum, a hernia may occur when the intestine gets stuck in the passage connected to the abdominal cavity.
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