HYDROCELE

AZIS AIMADUDDIN AI

Definition

an abnormal collection of fluid in the tunica vaginalis that may surround the testicle

Glenn's Urologic Surgery, 6th Edition. 2004

Campbell Walls Urology.10th Ed.2012

Caused by excessive fluid secretion by the visceral tunica albuginea without adequate reabsorption of this fluid by the parietal peritoneum around the testis

Anatomy

EMBRIOLOGY

Hydrocele

Non communicating hydrocele

Testicular hydrocele

Cord hydrocele

Communicating hydrocele

CLINICAL FEATURES

Testicular hydrocele

•Size didn’t change•Difficulty to palpate testis

Cord hydrocele•Size didn’t change•Mass upper the testis•Palpable testis

Communicating hydrocele

•Size bigger when crying or activity•Hydrocele sac separated from testis

Hystory taking: Painless scrotal swelling

Communicating hydrocele

An open processus vaginalis leads to varying amounts of serous fluid in the cavum vaginalis testis.

Non communicating hydrocele (testicular hydrocele)

Accumulation of serous fluid in the cavity of the tunica vaginalis of the testis, without communication of the hydrocele with the abdominal cavity

Non communicating hydrocele (cord hydrocele)

accumulation of serous fluid in a non-obliterated part of the processus vaginalis without communication with the abdominal cavity or tunica vaginalis of the testis

Testicular Tumors Epididymal cyst Spermatocele Hernia scrotalis

Differential Diagnosis :

Positive transilumination

Indication to surgical treatment

Some indications to perform surgery on hydrocele is: (1) a large hydrocele that can suppress the blood vessels, (2) an indication of cosmetics, and (3) permagna hydrocele which were interfere with the patient in performing daily activities.

Contraindication

Local Infection

Coagulation Disorders

Testicular neoplasm

Glenn's Urologic Surgery, 6th Edition

PROCEDUR Communicating hydrocele( high ligation )

Atlas Pediatric Surgery

Atlas Pediatric Surgery

Non Communicant Hydrocele PROCEDUR

Jabulay technic (testicle hydrocele)

Do marsupialitation and plication of vaginal tunica

Jaboulay procedure

Lord technic (testicle hydrocele)

Excise and plicate margin of vaginal tunica

Technical operation

For cord hydrocele, made blunt preparation to find hydrocele and do intoto extirpation

Post operative care

scrotal support.

analgesics.

Wound toilet

COMPLICATIONS

Early Complication Late complication

Hematoma. Infection.

Scrotal abscess Recurrent hydrocele Spermatocele

(Campbell-Walsh Urology, 10th. Ed. 2011)