Dropsy of the testis in men: surgical treatment, consequences and rehabilitation
Dropsy of the testicle can be treated with conservative methods, but only surgery to remove dropsy of the testicle can completely solve the problem.
There are several ways to perform testicular dropsy surgery; the choice depends on the patient’s condition and the opinion of the attending physician.
The skill of the surgeon and patient compliance with the necessary restrictions in the postoperative period guarantees a quick cure and eliminates relapse.
Testicular dropsy operation in men
Hydrocele or dropsy of the testicle is a pathology associated with the accumulation of serous fluid in the tissues of the testicle. The cause may be congenital non-closure of the appendix of the peritoneum. Such a defect is diagnosed in infancy and is corrected operatively.
In adult men, the cause of abnormal accumulation of lymph or pus in the cavities may be:
- sports injury go another option for mechanical damage,
- the consequences of the operation to eliminate varicocele, inguinal hernia, prostatitis,
- overvoltage when lifting weights,
- genitourinary infections (gonorrhea, chlamydia),
- severe heart failure
- improperly selected medications.
In the early stages of the disease, conservative therapy using medications and alternative recipes is possible.. In some cases, dropsy disappears on its own, usually it happens after the elimination of provoking factors (for example, medications that caused the accumulation of serous fluid).
However, the accumulation of a significant amount of fluid in the scrotum (from 1 liter or more) requires a more radical intervention. The operation of the hydrocele of the testis is also indicated in the presence of pus in the cavity accompanying the acute inflammatory process.
Puncturing: indications, features, conduct
One of the options for surgery for dropsy of the testicle in adults is puncture. Puncturing for hydrocele takes place in the laboratory and is recommended if it is impossible to carry out a classic operation.
Indications for puncture will be a significant accumulation of lymph, aesthetic problems (a strong increase in the scrotum), heaviness and pain, and a general state of discomfort.
The procedure is also recommended for recurrence of hydrocele that occurs after classical surgery. Puncture of dropsy of the testicle is contraindicated in exacerbations of hydrocele associated with extensive swelling and the appearance of pus, fever, severe pain in the scrotum.
Before the procedure, an ultrasound or diaphanoscopy is performed. A detailed study helps to avoid accidental injury to the testicle or large vessels.
- The procedure is performed under local anesthesia.
- The puncture is done with a thick needle to which a silicone tube is attached to drain the fluid.
- After a complete outflow, the needle is removed, the wound is treated with an antiseptic and closed with a sterile sticker.
The wound heals completely in a few days and does not require special treatment. Wearing a suspension or dense whitewash supporting the scrotum will help prevent relapse of testicular dropsy after surgery.
Options for interventions for hydrocele
Modern urology offers several options for operations. So, Winkelman’s surgery is often used for dropsy of the testicle and others. We will talk about how it goes and how long the operation of dropsy of the testicle in men lasts, we will discuss later in the article.
The choice of a particular method depends on the condition of the patient, the characteristics of his body, the presence or absence of other chronic diseases.
All operations are performed under general anesthesia, so the patient does not feel pain.During recovery from hydrocele, anesthetics are prescribed to relieve unpleasant sensations.
Wilkelmann operation. It is carried out under local or general anesthesia, the latter is more often used for hydrocele in children. An incision up to 5 cm long is made on the front of the scrotum, reaching the vaginal membrane. From there, the testicle is removed with a syringe, serous fluid is aspirated, the testicle shells are dissected, turned out and stitched.
In conclusion, a catgut suture is performed, drainage may be left in the wound. After the operation, a sterile dressing and an ice pack are applied to the incision site, which removes external edema. Bergman Method recommended for large volumes of serous fluid or a strong increase in the size of the testicle and thickening of its membranes. An incision is made on the front surface of the scrotum, the fluid is removed, then excess tissue is excised, and a suture is performed.
The technique is similar to the previous one, however, the inversion of the testicle shells is not performed. Usually, drainage is left in the wound for the outflow of accumulating fluid, it is removed after removal of the sutures. Lord's operation for hydrocele. It is done with a moderate amount of fluid and an enlarged testicle. The incision passes through the sac of water, after which the corrugation of the vaginal membrane surrounding the testicle is performed.
With this method, the risk of trauma to blood vessels and tissues is reduced. The operation is recommended for patients with a high risk of complications: blood clots, bleeding, edema.
We present to your attention: dropsy of the testicle in men, photos before and after surgery, as well as the testicle after surgery, hydrocele.
Recovery period: how to avoid relapse?
Surgery to remove dropsy of the testicle in men, affecting the peritoneum, requires a long postoperative period. It lasts at least a month, with particular attention to the body must be paid in the first week, while the seams have not yet been removed.
- All this time, the operation site is closed with a sterile dressing, it is changed daily.
- At the same time, the sutures are inspected and the healing speed is controlled. In case of mild inflammation, the seam is washed with a weak solution of potassium permanganate or treated with a swab with chlorhexidine.
In the early days, bed rest is very important. Any sharp movement, tilt, tension can provoke divergence of sutures and bleeding.
In the absence of complications, sutures from mylar threads are removed after 7 days. The advantage of catgut sutures in their resorption, when using such suture material, the seams are not removed.
During the recovery period, the patient is prescribed a sparing diet of easily digestible nutritious dishes.
- Cooked and stewed vegetables without spices, fruit purees, low-fat fermented milk products, liquid cereals on water, vegetable soups, steamed fish and poultry dishes are recommended.
- Alcoholic drinks, fried, fatty foods, smoked meats, canned foods and pickles are excluded. It is important to monitor digestion, avoiding diarrhea, constipation and other intestinal disorders. Any strain and infection of the wound is dangerous for the patient.
Care after surgery hydrocele is not difficult. During rehabilitation after removal of hydrocele, the patient should not lift weights and engage in active sports.
Sexual life is allowed no earlier than 6 weeks after the removal of stitches, preliminary consultation with a urologist is recommended. In the first month after surgery, bathing and sauna access are prohibited.
Hygiene procedures are limited to a warm shower with neutral detergents.
During the entire postoperative period, the patient must wear a special bandage after the operation of dropsy of the testicle, ensuring the normal position of the scrotum and preventing the re-accumulation of fluid. It can be replaced with elastic swimming trunks made of dense cotton knitwear.
Consequences after surgery
Like any surgical intervention, removal of fluid from the seminal cavities can be fraught with complications. The consequences after surgery for dropsy of the testicles in men are divided into early and late, the risk of occurrence is associated with the skill of the surgeon and the characteristics of the patient's body.
Young and active people without chronic diseases and the presence of infections experience dropsy surgery much easier, and unpleasant consequences occur less often.
- One of the earliest postoperative problems is seam divergence.. The reason is the individual reaction of the patient's body, as well as non-compliance with bed rest. It is easy to detect the problem - the wound begins to bleed, possibly inflammation and separation of pus. The patient is prescribed antibiotics, the suture is restored under local anesthesia.
- After anesthesia has ended, the patient may experience pain. Usually it is dull and aching, sharp short-term flashes are possible. If a testicle hurts after a hydrocele, the patient is prescribed nonsteroidal drugs, analgesics, and anticonvulsants to relieve unpleasant symptoms. In acute pain in the scrotum, novocaine or lidocaine blockade is possible, but this treatment option is used relatively rarely.
- A very common complication after hydrocele surgery is testicular edema.. The scrotum increases in size, after the operation the hydrocele is the testicle is solid and clearly felt on palpation. Edema is usually localized in the suture area, at this point a seal is felt, which can be painful. The cause of edema is an inflammatory process that is suppressed by a short course of antibiotics.
Another reason is the body's reaction to suture material. When using lavsan threads, edema lasts 3-4 weeks, with more sparing catgut threads it subsides after 4-7 days. In very rare cases, rejection of suture material is possible; repeated dropsy surgery will help correct the situation.
Men suffering from dropsy of the testis should not be afraid of interference. Now you know how to perform testicular dropsy surgery.
Proven techniques quickly eliminate serous fluid, preventing unpleasant complications. The patient almost does not feel pain, subject to all doctor's prescriptions, the postoperative period passes quickly and leads to complete recovery.
In conclusion, we bring to your attention the form of how Bergman’s operation takes place with dropsy of the testicle.
Causes of testicular dropsy
It is important to understand that testicular dropsy surgery is not indicated for all male patients. So, the hydrocele formed in the baby congenitally, as a rule, goes away by itself at 1.5 or 2 years and does not require surgical removal. At the same time, the causes of the formation of pathology in children and adults differ. So, in newborn babies, dropsy is formed for the following reasons:
- Injury to the scrotum of the baby during childbirth,
- The formation of the internal channel through which the abdominal cavity and scrotum communicate with each other,
- Underdevelopment of the lymph vessels of the testes in the baby.
Important: most often, dropsy surgery in these cases is not needed. Pathology is simply observed until it passes on its own. Surgery is used only as a last resort.
In boys from 3 years old and in adult men, hydrocele develops for the following reasons:
- Previous surgical procedures for varicocele or inguinal hernia,
- Injury to the scrotum and testes,
- Benign and malignant tumors in the testicles,
- Inflammatory processes of the testes (epididymitis, orchitis, etc.),
- Filariasis (an infectious disease transmitted through mosquito bites in hot countries).
Important: testicular hydrocele operation is mandatory and urgent if the total volume of accumulated fluid is 50 ml or more. Symptom of such a pathology is the scrotum is too enlarged on one side and the testicle is not palpating.
The consequences of the operation
It is important to understand that dropsy of the testis after surgery requires close monitoring by the surgeon, since the manipulation in some cases can lead to various kinds of complications. The most common are:
- Soreness in the groin area lasting about a week (manifested during walking),
- Swelling of the joints,
- Retention of urine outflow
- Inflammation of the sutures and purulent discharge from the wound,
- Decreased libido
- Allergic reactions to medication.
- The formation of a hematoma in the area of surgical intervention,
- Decrease in general sensitivity from the inside of the thigh (suggests that the inguinal nerve is affected).
Important: relapse may occur after testicular hydrocele. But this is only possible if a puncture was performed to remove the accumulated fluid, and not a full operation.
The rehabilitation period after surgery is approximately 30 days. But for each patient, the recovery period is individual, depending on the general condition of the body, age and characteristics of the immune system. In general, recovery after hydrocele operation includes a number of such recommendations and measures:
- Wearing a sterile antiseptic dressing for a week after surgery with its constant daily replacement,
- Removing sutures from mylar threads a week after the intervention,
- Treatment of the wound surface with a diamond solution or a solution of manganese to form a protective scab, which will then fall off,
- The ban on taking hot baths and bathing in public reservoirs until the wound is completely healed and a cosmetic scar is formed,
- Refusal of sexual activity for a month until the pain syndrome and wound healing completely disappear,
- A ban on physical activity with weight lifting for a period of up to a month,
- Observation by the attending physician in the first six months after elimination of fluid from the scrotum.
It is important to understand that the operation itself to remove dropsy is not complicated and takes only 20-30 minutes. However, in the postoperative period, it all depends on the patient himself. Exact observance of all recommendations allows you to avoid complications and return to your usual lifestyle as soon as possible.
Winkelmann's operation for children is performed under general anesthesia, for adults under local anesthesia. In the area of puffiness, an incision of about 5 cm is made. All membranes to the peritoneal process are cut in stages. After that, the testicle is brought out.
Using an aspirator, the surgeon removes fluid from the scrotum, the peritoneal membrane is cut. Then, the viability of the testis and its appendages is assessed. Further actions are carried out according to the Winkelmann scheme. The surgeon turns the edges of the sheath and hem them.
Subsequently, soft tissues will absorb the fluid produced by the peritoneal process. The lumen of the vaginal process is sutured. After suturing, a drainage tube is inserted into the wound, preventing the development of extensive edema and bruising. After surgery, an ice warmer is applied to the affected area. Removal of sutures is not required, after 2 weeks they dissolve by themselves. A retaining dressing is put on the scrotum.
Video: "What is a hydrocele?"
Bergman removal of hydrocele carried out in case of accumulation of a large amount of liquid and compaction of the shells. The first stages of the operation are performed according to the previous scheme. A small incision is made, after which all tissues are dissected in layers.
The testicle is removed from the scrotum, the fluid is removed using a syringe. The vaginal membrane is dissected, its excess is removed, the remaining tissue is sutured with catgut sutures. After this, the testicle is returned to the scrotum, the skin is sutured. Ice and a retaining dressing are applied to the scrotum.
The operations described above are the most common and effective. Entrusting their conduct is necessary only to an experienced surgeon. Before starting treatment, you should study the reviews, because these surgical interventions can lead to various complications. Tissues and blood vessels are damaged, which leads to hemorrhages. Lymph outflow is disturbed, due to which the inflammatory process develops.
Under the operation of the Lord the risk of complications is assessed as minimal. By this method is meant surgical intervention, in which the doctor cuts the testicle and sutures the peritoneal process.
The sex gland itself does not separate from the surrounding tissues and is not excreted. Such operations with hydrocele are considered the most effective and safe.
One of the simplest methods of surgical treatment of dropsy is puncture. Using a thick needle, a puncture is made through which excess fluid is pumped out.
Removing dropsy of the testicle in this way has a significant drawback - the possibility of a re-occurrence of the disease. In this case, the operation will have to be done more than once.
Ross Method used in the treatment of communicating hydrocele in boys older than 2 years. It is also prescribed in the presence of inguinal hernia or an infectious disease that contributes to the formation of inflammatory exudate.
Other indications for such surgery are severe pain in the inguinal region, the possibility of atrophy of the scrotum, and large organ sizes that interfere with walking. Ross operation for testicular dropsy is aimed at stopping the movement of fluid from the abdominal cavity into the testicle membrane.
Video: "Testicular dropsy surgery"
Dropsy of the testicle in men can be eliminated with the help of modern less traumatic methodsthat are currently becoming increasingly popular.
Their main advantages are:
- minimal risk of complications
- short duration of the procedure
- lack of need for general anesthesia.
The recovery period proceeds without any difficulties., the risk of injury and infection of tissues is minimal. The patient may return home the day after surgery. Healing of small incisions occurs without the formation of rough scars.
With dropsy of the testicle operation can be performed by sclerotherapy. Liquid is pumped out of the testicles, after which a special substance is introduced. It causes an aseptic inflammatory process and further tissue adhesion. This contributes to the fact that the cavity disappears in which the liquid could accumulate. Relapses are observed in no more than 1% of cases.
After endoscopic surgery, the patient can go home on the same day.. An anesthetic drug lasts 3-4 hours, after which discomfort appears. In most cases, they have a low degree of severity, so they can be tolerated.
If you have severe pain, your doctor may recommend taking painkillers. Depending on the individual characteristics of the body, unpleasant sensations disappear after 5-10 days. The intensity of the pain will decrease every day.
In the early postoperative period, the patient must observe strict bed rest.. You can not get out of bed, walk and sit down. Any physical exertion must be avoided. Walking is allowed for 2 days after the operation, but this is only necessary if there is a need for eating, going to the toilet, or performing dressings.
Sleep better on your back or side. After 2-3 days you will need to visit the treatment roomwhere drainage will be removed and the dressing replaced. Within 10 days, the wound should be treated with furatsilinom or brilliant green.
Examination of the patient is carried out 2 weeks after surgery. Over the next month, heavy physical exertion should be avoided. As a rule, a disability certificate is issued for 7 days.
After this time, the man’s condition improves, and he can return to work. For complete healing of the suture, at least 4 weeks are required. If the patient's professional activity is associated with a prolonged sitting position or weight lifting, the duration of the period of incapacity for work increases to 21 days.
The most common consequence of surgery is re-accumulation of fluid.
There is always a risk of damage to the testis, spermatic cord, or blood vessels that feed the genitals. In the future, this can lead to infertility.
The risk of developing complications largely depends on the qualifications of the surgeon and the method of treatment used. An equally common consequence of fluid removal from the scrotum is testicular displacement. After surgery, a man may notice that it is above normal position. In this case, it is necessary to consult a doctor.
To the wound bacteria can enter, which will lead to the development of the inflammatory process. This problem is solved by a course of antibacterial therapy. Prolonged pain in the suture area indicates damage or pinching of tissues.
Unpleasant sensations usually disappear after 6-12 months after surgery. An extensive hematoma can form in the scrotum, which eventually resolves spontaneously. Repeated surgery for dropsy of the testicle requires 1 patient out of 100. The most rare complications are problems with urination, varicocele and erectile dysfunction.
Dropsy of the testicle in men: treatment, causes, surgery, symptoms, consequences, rehabilitation
What is a hydrocele, how this disease manifests itself, what treatment is supposed for it, is of interest not only to adult men, but also to young mothers of young boys.
In medical terminology, this is a condition in which a pathological increase in the scrotum due to the accumulation of fluid between the shells of the testicles is observed.
At the same time, there is an increase in the volume of the scrotum, in some cases accompanied by unpleasant sensations.
Pathology of the testicle is an increase in the scrotum due to the accumulation of fluid between the shells of the testicles.
In children, in the first months of life more often passes independently without treatment. In adults, it requires medical intervention.
Causes and classification
There are several criteria to classify dropsy. If we consider the causes of hydrocele, then allocate:
- Congenital form of the disease.
- Acquired. It develops in men against the background of local inflammation, trauma, after surgery.
Congenital hydrocele of the testis is divided into:
- A simple option when the canal is completely closed between the scrotum and the abdominal cavity.
- Communicating testicular dropsy while maintaining communication.
- Depending on the course of the disease, acute or chronic.
- Based on the side of the lesion - unilateral or bilateral.
- The liquid that accumulates between the shells is different in composition:
- Homogeneous, non-inflammatory - transudate.
- Purulent - exudate.
- Hemorrhagic (blood).
Such a multifactor classification is of practical importance, since on its basis the surgeon will determine the further treatment tactics.
Dropsy of the testis in men: surgical treatment, consequences and rehabilitation
Hydrocele, or dropsy of the testicle, is one of the rare, but still unpleasant pathologies of the male reproductive system. Dropsy is characterized by the accumulation of fluid in a volume of 30-200 ml between the membranes of the testis (testis). As a result, the scrotum increases in size, while there is no pain even when moving. They treat pathology in most cases promptly. How is the surgical intervention, and what consequences after the dropsy operation in men can be, we analyze below in the material.
Hydrocele removal surgery and its consequences
Dropsy of the testicle or hydrocele is exclusively a male disease that occurs in 10% of newborn boys and approximately 1% of adult men or adolescents.
Most often, the accumulation of fluid in the area of the membranes of the spermatic cord does not pose a health risk and passes on its own without surgical intervention.
However, if there are indications (for example, testicular pathology or the development of hydrocele as a complication of hernia repair), surgery may be necessary to remove testicular dropsy.
Today, such surgical intervention is performed using minimally invasive methods and usually does not require long-term rehabilitation.
What is hydrocele and its causes
The term “hydrocele” arose in Ancient Greece as a result of the combination of two words: “hydro” - water, and “cele” - bloating, expansion. As a rule, we are talking about a one-sided accumulation of fluid, which can cause not only a visual increase in the volume of the testicle, but also in rare cases provoke impaired urination, problems during sexual intercourse and even a violation of the blood supply to the testicle and its atrophy.
Hydrocele is congenital and acquired in nature.
In the first case, the baby is born with dropsy of the testicle, which may be:
- communicating (the vaginal process remains completely open and part of the intestine may fall into it, which provokes a combination of hydrocele with an inguinal hernia),
- isolated (the vaginal process is partially overgrown, has no communication with the abdominal cavity, and the isolated cyst is the place of fluid accumulation),
- cystic, funicular (characterized by overgrowth of the upper and lower parts of the process, and the middle section turns into a cyst).
According to statistics, preterm babies most often have hydrocele, however, dropsy symptoms in most cases disappear when the boy reaches 12 months of age.
Acquired dropsy can provoke:
- inflammation or tumors with localization in the scrotum,
- tuberculosis and other testicular infections,
- heart failure (provokes a violation of the outflow of fluid),
- parasitic diseases.
In some cases, a violation of the outflow of fluid is provoked by age-related changes in older men.
The development of dropsy is one of the possible complications of surgical intervention in the scrotum associated with varicocele, inguinal hernia.
Stages of the disease and their symptoms
Depending on the location, the hydrocele can be single or double-sided.
In advanced cases, an intense testicular dropsy can be diagnosed, in which significant swelling and enlargement of the scrotum occurs.
The reason for this is valve communication with the abdominal region, which prevents the flow of fluid from the scrotum.
In most cases, the only external manifestation of the pathology is a noticeable increase in the scrotum, which does not cause pain and does not cause anxiety.
In rare cases, a feeling of heaviness may occur with increased swelling and pain in the evening.
If there is a significant increase in the size of the cavity with the liquid, the following are possible:
- problems with urination
- sexual disorders
- the development of inflammation,
- the appearance of hematomas,
- violation of local blood flow followed by testicular atrophy.
Even in the absence of unpleasant symptoms at the initial detection of hydrocele, it is necessary to consult a doctor, as an inguinal hernia and some other processes can also provoke dropsy.
Video: “What is hydrocele (dropsy of the testicle)?”
Surgical treatments for hydrocele
It’s not always necessary to resort to surgery to treat dropsy. In most children and adults, the disease goes away on its own within a few months. However, if the disease causes discomfort or is accompanied by an inflammatory process, surgical intervention is indicated.
The patient also has to be operated on in the presence of inguinal hernia. Surgically eliminate dropsy in men older than 65 years.
Today, 4 basic methods of surgical intervention for hydrocele have been developed - the operations of Ross, Lord, Winkelman and Bergman.
The choice of a specific method is made by the doctor, depending on the type and size of the dropsy of the testicle, which is diagnosed in a particular patient.
Video: Operation Ross
The benefits of the most effective method
Lord’s operation involves minimal trauma to the testicle and blood vessels. The doctor dissects the testicle shell and, after removing the accumulated fluid, provides corrugation of the sheath of the vagina. This technique is used to eliminate recently formed dropsy, provided that the testicle has not yet acquired increased rigidity.
The operation according to Ross's technique is aimed at eliminating the communication between the abdominal cavity and vaginal processes. In this case, suppression and partial removal of the vaginal process occurs. Part of the process is bandaged, and at the lower end there is an opening for the exit of fluid.
The operation according to the Winkelman technique is indicated for small dropsy. In this case, the hydrocystic cyst is simply dissected, turned out and stitched around the testicle in an altered form.
With large sizes, hydrocele resort to the operation according to Bergman’s technique, which involves the removal of a portion of the testicle shell, followed by stitching of the remaining portion.
What complications and consequences can occur after surgery?
In most cases, complications after surgery do not occur, but in some cases, the following can be noted:
- infection of the postoperative wound with the development of the inflammatory process,
- joint discrepancy, which is usually caused by non-compliance with the motor regimen recommended by the doctor,
- accumulation of lymph in the scrotum,
- individual reaction to the weld material,
- pathological scarring.
Relapses of hydrocele, change in the appearance and shape of the scrotum are extremely rare. If the spermatic cord is accidentally damaged during the operation, this can cause infertility.
Most often, on the day of surgery, the patient can go home.
A few hours after the completion of the operation, pain occurs due to the termination of the action of painkillers.
If the pain is excruciating, additional pain relief is permissible during the first two days. Completely pain syndrome disappears in 3-7 days.
The recovery period lasts 7-10 days, during this period it is recommended to lie maximum on your side or back. It is important to avoid any physical exertion, you can not sit. You can walk only for short distances.
Rehabilitation procedures and care
Within a week from the date of the operation, the wound must be covered with a sterile dressing. If the seam is performed not with catgut, but with lavsan threads, in the absence of complications they are removed after 7 days.
During the rehabilitation period, it is recommended to abandon tight clothing; in some cases, wearing suspensories is indicated.
2-3 days after the operation, ligation and drainage replacement in a hospital will be required. After that, during the week it is necessary to do dressings on your own with a daily wound treatment with a solution of brilliant green.
You can take a shower no earlier than a day after the operation.
On the 10th day from the date of surgery, the condition of the wound should be examined by a doctor. It takes up to 5 weeks to fully heal. If the patient’s work is associated with prolonged sitting or physical activity, it is recommended to remain on sick leave during the recovery period.
Operation for dropsy of the testicle in adults
Hydrocele in men may not require treatment if it does not cause any discomfort, in other cases, surgery is the best solution. Sclerotherapy can be an alternative to surgery for dropsy of the testicle, which you can read about in the article “Sclerotherapy or surgery - which is better?”.
Before surgery for dropsy of the testicle
Before surgery, you must stop smoking. Try to reduce body weight if you are overweight. If you have problems with pressure, heart, lungs, be sure to consult your doctor before surgery.
Arrange in advance with a friend or relative who will be able to accompany you to the hospital and take you home after the operation. You will be examined at the hospital to rule out any infectious and inflammatory diseases, you will need to pass a number of tests, this will help make sure that you are fully prepared for the operation. At present, you can take all tests before surgery a few days before treatment in a clinic or outpatient department at the clinic.
Immediately before the operation, the surgeon and anesthesiologist will talk with you, the doctors will explain in detail what will happen during the operation, what are the risks and complications of surgery and anesthesia. After the interview, you sign an informed consent for surgery and anesthesia.
Surgery for dropsy of the testicle can be performed under general anesthesia, i.e. you will be unconscious throughout the operation. Sometimes surgery can be performed under spinal or epidural anesthesia, that is, the doctor will use a special needle to inject anesthetic into the area of the spinal canal, which will anesthetize the area below the injection. At the same time, during the operation you will be conscious and feel the actions carried out in the area of the surgical field, but you will not feel pain.
Before surgery, it will be necessary to shave the area of the scrotum. If the operation is performed under general anesthesia, then it is forbidden to eat on the day of the operation, the last meal is allowed the night before. If these conditions are not met, surgery will be delayed. If the operation is performed under local anesthesia, then the day before you can eat a light breakfast.
Operation for dropsy of the testicle
An incision 4-5 cm long is performed on the scrotum in the projection of a hydrocele. The layers of the scrotum and testicle are sequentially dissected. The testicle is removed into the wound. The hydrocele liquid is aspirated. Part of the fluid is sent to the study to exclude the presence of another pathological process. Next, the surgeon examines the testicle. If all is well, plastic is performed on the testicle shell to prevent re-accumulation of fluid in its cavity. If the urologist sees that the testicle is pathologically altered, then a decision may be made to remove it, as a rule, this happens with testicular cancer, sclerosis, etc. (your doctor will definitely discuss this option with you before surgery).After performing plastic sheaths, the testicle descends into the scrotum, and the wound is sutured with absorbable sutures. At the surgeon's discretion, drainage may be left in the wound to prevent accumulation of fluid in the scrotum.
Testicular sheath repair can be performed using the method of Lord, Bergman or Winkelman. The choice of methodology depends on the size of the hydrocele and the thickness of its shell. During Bergman’s surgery, after dissection of the membrane, it is completely excised, and during Winkelmann’s surgery, the vaginal membrane is turned inside out and sutured. The Lord’s technique has the advantage that the testicle does not enter the wound, which helps to reduce the trauma of the scrotum structures.
Excised tissues during surgery are sent for histological examination. The operation lasts 20-30 minutes.
Surgery for dropsy of the testicle in adults is a one-day procedure. This means that on the same day you can go home. If you are over fifty years old, or have problems with urination, heart, pressure, you can stay in the clinic for one or two days for postoperative observation.
After the operation - in the clinic
After surgery, you may experience slight discomfort while moving. Analgesic pills easily solve this problem. If the pain syndrome is significantly pronounced, then the doctor may prescribe you painkillers administered intravenously or intramuscularly.
General anesthesia can make you inhibited, forgetful the first 24 hours after surgery. In no case do not drive the car after the operation, think in advance about how you will get home.
It is very important that you empty your bladder in the next 6-12 hours after surgery. If you have trouble urinating, notify your doctor or nurse. In this case, you may need a single bladder catheterization to drain accumulated urine.
After surgery - at home
The wound is sutured with absorbable sutures, which usually disappear seven to ten days after surgery. Sometimes this process may take a little longer. If resorption of the sutures has been delayed for more than 10 days, notify your doctor, but do not try to remove them yourself.
You can take a shower and wash, but try to keep the postoperative wound dry for the first ten days.
At first, avoid heavy physical exertion, do not lift heavy objects. A month after the operation, you can lift weights and return to the level of physical activity that was familiar to you before the operation.
Sex life can be resumed one to two weeks after surgery, when the wound heals.
Possible complications of testicular dropsy surgery
If the operation is performed under general anesthesia, there is a low risk of developing anesthetic complications from the heart and lungs.
Complications of the operation with dropsy of the testicle develop extremely rarely.
Swelling and hematoma formation in the area of the surgical wound can cause discomfort, while swelling can reach the same size as hydrocele. The swelling may persist for four to six weeks after surgery. Wearing tight-fitting underwear can help you solve this problem.
Sometimes bleeding may develop in the area of the postoperative wound - pressure on this area helps stop bleeding. In some cases, another operation may be needed to stop the bleeding.
Infection is a rare problem that is easily resolved by taking antibiotics within one to two weeks.
Another even more rare complication may be infertility (inability to conceive a child). This occurs if during the operation the structures of the spermatic cord are damaged.This complication is especially undesirable if the second testis and spermatic cord are also compromised.
The likelihood of re-development of testicular dropsy is less than one in twenty cases.
What is testicular hydrocele
- Hydrocele is a one-sided process of increasing in size half of the scrotum, bilateral is rare, can indicate the presence of serious diseases.
- The liquid accumulates in volumes from a couple of milliliters to 1 and even 3 liters (the latter happens in advanced cases).
- But, nevertheless, there is the likelihood of a simultaneous occurrence of dropsy of both the right and left testicles.
- The treatment is exactly the same.
Causes and symptoms
For a long time, the patient does not feel anything, since the process of dropsy formation is painless. A trip to the doctor is justified mainly by cosmetic inconveniences (when going to the bathhouse, to the beach.).
Here are the most common causes of testicular hydrocele:
- As a complication after surgery (kidney transplantation), varicocele.
- It occurs in parallel with another disease, when the epididymis becomes inflamed, with gonorrhea, tuberculosis.
This problem can be born or acquired.
Until the 20th century, dropsy of the testicle was a consequence of gonorrhea.
- Often - this is the result of injuries, and it is so small that a person does not even pay attention to it.
- After 2 or 3 weeks, a tumor forms and begins to slowly grow in the damaged half of the scrotum, without creating pain.
- In chronic cases, this lasts a couple of years, without leading to any disorders.
- The inconvenience begins when the dropsy reaches a large size (even with the baby’s head), there are problems with urination, sexual disorders.
- Diagnosis of hydrocele is that the diseased area of the scrotum is palpated and examined, revealing the disease itself, its stage, checking for tumors, it is important to do an ultrasound.
- It will show the amount, volume of accumulated fluid, it will become clear whether everything is in order with the epididymis.
How to treat dropsy without surgery
Hydrocele is treated with medication and surgery, but the latter method is not applicable to children with congenital dropsy up to 1-1.5 years old, it is not always allowed for the elderly.
When a disease is detected, it is treated by puncture, and fluid is extracted from the dropsy. But this method is called diagnosis rather than treatment.
After six months, dropsy can again make itself felt.
This procedure is done mainly for elderly patients, when surgical intervention is unacceptable or they simply refuse it and want to forget about difficulties with an aesthetic appearance for some time.
The countries of Europe and the USA approach the treatment of the disease with the help of new modern methods and technologies - they produce sclerosis of the testicle shells.
First, liquid is sucked out of the dropsy, then sclerosants (drugs) are introduced into the cavity, the effect of which is that they suppress the production of liquid in the dropsy itself. This fluid is produced by the shell around the testicle.
The procedure is carried out once or 2 times, for the effect. But the administered drug also has contraindications, it can damage tissues in the testicle.
More often this method is used in older people who are not able to perform surgery.
With surgical intervention, plastic testicular membranes are performed, which is considered the most optimal in the fight against this disease.
Here are operations that are superior to others:
Which of these methods to apply is determined by the doctor during the duration of the operation.
For example, with an excess of shells, their thickening (large dropsy sizes), the methods of Winkelmann and Lord are rejected.
According to the Lord’s method, they will not be operated on when the disease has become chronic, since the corrugation of the hard shells of the testicle will lead to an unnatural appearance of the scrotum and damage the aesthetic appearance.
Operations with hydrocele of the testicle Winkelmann and Bergman are more traumatic compared with the Lord's method. This is due to the fact that hypotrophy of the testis occurs, disruptions in the production of testosterone and sperm occur.
In these situations, Bergman surgery remains, in which the anterior surface of the scrotum lends itself to a five, six centimeter incision, which is done in layers.
Then the testicle is removed. The fluid from the testicle is pumped out with a syringe. The vaginal membrane is excised around the testicle itself.
Catgut sutures suture the dissected membrane that remains. Then, the testicle is returned to the scrotum, the layers of the scrotum and skin are sutured in layers.
A small rubber drain is done in the wound at the end of the operation to drain excess fluid. The ice is put in place of the surgical intervention in the first 2 hours after the operation so that the hematoma does not develop.
In ten days, complete resorption of the seams will occur.
It is recommended to wear tight swimming trunks the entire first month, you can impose a suspension on the scrotum.
Lord's Surgical Technique
When a hydrocele is small, it would be wise to operate according to the Lord’s method, which is the least traumatic. Open the cyst of the sac, after having made a dissection of the skin, testicle shells.
The testicle is removed into the wound, stitches with constricting properties are placed on the pouch (the suture is absorbed).
At the end of the operation, the testicle returns back to the scrotum, the wound is sutured layer by layer, the drainage is not done, but a pressure bandage is applied.
With this operation, access to the shells of the testis through an incision is opened, as with Bergman's operation. The clamp helps to expand the shell.
The testicle is removed into the wound, the serous substance is removed. Periosteal membranes are turned inside out and stitched.
The principle works as follows: the epithelium forms a fluid that accumulates between the leaves, and after the operation, the surrounding tissues absorb the fluid.
Adults are first given local anesthesia, and children are given general anesthesia.
Between the inguinal canal and the cavity of the scrotum, there may be some message, the vaginal process, the lumen are sutured. Apply catgut sutures, install drainage.
- After all types of surgery, antibacterial and anti-inflammatory therapy is additionally carried out.
- The longer you wait, run the disease, the more difficult the treatment will be.
- And trusting your health to any specialist, you need to be completely confident in him, because any mistake made during the operation leads to a relapse.
Help folk remedies
Hydrocele treatment is a complex process that requires only an individual approach in the choice of methods.
Self-medication can provoke a worsening of the condition, so even the use of the simplest means requires a consultation with a specialist.
In the traditional treatment of hydrocele, surgery is required. Home treatment avoids surgery and prolonged subsequent rehabilitation.
Many patients use folk methods and most of them, judging by the reviews, are effective:
- Pea compress. A decoction is used, in which peas were cooked for 1 hour. In the liquid you need to dip a clean cotton cloth and attach to the sore spot. The broth must first be cooled to room temperature. The procedure takes about 15-20 minutes. The use of a pea compress is needed once or twice a day. If after 3-4 days there is no improvement and the scrotum still grows in size, the treatment should be stopped and immediately go to the hospital.
- Parsley decoction. It is prepared only from fresh leaves of the plant (800 g) and only fresh milk (1 l). Parsley with milk should be cooked in the oven for 4 hours.A filtered broth should be drunk every hour throughout the day for 30 ml. The prepared product should be used in the first day. The next day, the medicine is prepared again.
- Cinnamon and coltsfoot in dried form are used in the preparation of infusion. Raw herbs are taken in equal proportions and infused for 30 minutes. To relieve symptoms of hydrocele, it is indicated to drink at least 4 tablespoons 5 times a day. The components of this agent have a decongestant effect and help remove fluid from the scrotum.
- Calendula ointment with the addition of baby cream, easy to use and effective. Components are used in equal shares. Healing ointment is applied to the diseased testicle daily at bedtime. After application, the product is covered with a bandage and you need to wear thick warm underwear. You need to use this recipe until the dropsy passes.
- An ordinary pulp in the amount of 100 g is boiled in one liter of white wine for about 5 minutes. The resulting broth must be filtered through a fine sieve. Such a medicine is used as gauze lotions for dropsy for 30-40 minutes. This should be done at least 2 times a day until the fluid is completely removed from the scrotum.
- Chamomile flowers, especially freshly picked, help to remove signs of hydrocele at the beginning of formation. The plant must be passed through a meat grinder and the resulting slurry should be applied to the swollen testicles. It is enough to carry out such treatment for 20 minutes at a time 3 times a day. The anti-inflammatory and deodorizing substances of the plant help get rid of dropsy of the testicles in 10 days.
- You can take hemp pulp, which, like most medicinal herbs, you need to take as herbal tea.
- Herbal collection of chamomile, sage, blackcurrant, jaundice should be taken as a decoction for 20-30 days. Before eating.
- It is recommended to use lotions from sheep bile with honey in the treatment. The method is effective subject to periodic use.
- You can drink an infusion of lily of the valley leaves or a decoction of flaxseeds.
All folk recipes are safe for health. The uniqueness of each of them lies in the targeted effect on the hydrocele, as a general strengthening of the body of a man.
The use of spicy and fatty foods provokes the growth of dropsy of the testicle rapidly. Alcohol, smoked meats, carbonated drinks are not recommended. Exacerbation of hydrocele helps eating heavy foods, especially meat.
During the period of hydrocele disease are shown:
- Pumpkin juice, in an amount of 100 ml, copes with the function of removing excess fluid. It is good for men to eat other pumpkin dishes.
- Onion juice with sugar. The drink is prepared in the evening, at the rate of 2 finely chopped onions and a pinch of sugar at a time. Overnight, the onion will release all the liquid that you need to take in the morning.
- An indispensable product in the fight against dropsy is grapes. Every morning, ten berries for a month and signs of dropsy of the testicle disappear.
- Healing decoction of watermelon peels, a popular diuretic.
- Some people prefer a vegetarian diet during exacerbation of hydrocele, with the predominant use of cucumbers, eggplant, fresh cabbage.
- Instead of tea or the usual coffee, it is shown to switch to freshly squeezed juice of black radish with the addition of natural honey.
- A healthy dish for men from grated horseradish roots with lemons.
- You can prepare a healing salad of watermelon, citrus and apples.
Along with proper nutrition, doctors advise a three-day fasting. Effective in the fight against hydrocele massage of the scrotum.
Consequences and Complications
The risks of self-medication can cause significant complications. Before using traditional medicine, you should consult a urologist or surgeon. Doctors rarely insist on surgery, this is a cardinal method.Proper treatment will help get rid of unpleasant symptoms quickly.
The risk group consists of men over 20 years old. The occurrence of dropsy of the testis has a bad effect on reproductive function. An inflamed testicle impairs sperm quality. The appearance of dropsy is accompanied by a lesion of the urinary system, kidney function deteriorates. Drug therapy in the treatment of this disease does not exist.
Most conservative methods are used:
- Respect for a moderate lifestyle
- Antibacterial agents
- Evacuation of fluid by puncture.
These methods do not permanently eliminate hydrocele. Only surgery can get rid of the disease and its complications.
The inflammatory process that occurs with pathology provokes an increase in the scrotum in size. The rate of development of the disease depends on the patient’s immunity, the presence of acute or chronic diseases. Doctors advise to avoid trauma to the genitals, which can provoke the development of hydrocele.
An important preventive measure is getting rid of parasitic diseases at the first sign. Chlamydia can cause testicular dropsy, so an ordered sexual life is an important condition for preventing hydrocele.
Inflammation of the epididymis in 55% of cases provokes the development of pathology. The disease is complicated in the treatment by the fact that in 100% it recurs. Prevention of hydrocele is important for all men, without exception, especially under the age of 35 years.
Doctor: Shishkina O.A. ✓ Article checked by doctor
Surgery for hydrocele (removal of dropsy of the testicle): indications, methods, rehabilitation
All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting a doctor.
A hydrocele or dropsy of the testicle is an accumulation of liquid contents between its shells. The reasons may be different: in children - non-closure of the peritoneum, in adults - trauma or inflammation. The disease usually manifests itself only in an increase in the size of the scrotum, in rare cases, discomfort during intercourse or urination is possible.
The most common surgical treatment: minimally invasive (puncture, sclerotherapy) or radical (suturing of the testicles). Surgery for hydrocele must necessarily be accompanied by therapy for the underlying disease that caused the dropsy. Otherwise, the effect of the intervention will be temporary.
Preparation for surgery
To clarify the diagnosis, the doctor can prescribe the following studies:
- Diaphanoscopy. Through an enlarged testicle shine a flashlight. Water transmits light in almost unchanged form. Through a denser formation (tumor), it does not pass. The procedure is not performed after a recent surgery on the scrotum or testicular inflammation. In this case, blood can accumulate in the space between the membranes, which also does not allow light to pass through.
- Ultrasound It is prescribed when there are difficulties with the diagnosis. Ultrasound helps distinguish dropsy from a tumor or hernia.
Before general anesthesia (for surgery, small children) undergo a standard list of procedures:
- ECG (electrocardiogram).
- General analysis of blood and urine.
- Research on a number of infections - hepatitis, HIV, etc.
- Blood chemistry.
- Clinical blood test - determination of blood flow velocity, coagulation and other parameters.
- Visiting specialist doctors in the presence of chronic diseases and obtaining their permission for surgery.
- Reception of the therapist and issue of the conclusion.
Before the operation, it is necessary to cure all existing inflammatory reactions - colds, tooth decay, etc. If the patient is unwell, surgery should be delayed.
Before surgery for dropsy of the testicle, men need to shave the pubis and scrotum, take a hygienic shower. Starting in adolescence, the intervention is performed under local anesthesia. You can return home a few hours after the operation.
Children are sometimes left in the hospital overnight.
This type of intervention is considered as a temporary way to improve the condition when radical surgery is impossible. Usually the effect lasts about six months.
The doctor injects the anesthetic into the puncture site. After that, he punctures the testicles with a thin needle and sucks out the liquid. The puncture is sealed with a sterile adhesive.
This is one of the new modern methods that is actively practiced in Europe and the United States. In Russia, it has not yet been mastered by all clinics and medical centers. It is indicated for older people who have already lost their reproductive function.
The doctor sucks the liquid contents from the space between the testicle shells and injects a gluing agent there. It affects the tissue of the scrotum, as a result of which the secret ceases to be produced.
This operation to remove the hydrocele is very similar to the previous one. The only difference is that excess tissue is not bent, but cut. A temporary drainage is installed. Fabrics are sutured in layers, then sutures are applied to the skin. A bandage is placed on the scrotum.
Bergman's operation is carried out with a large testicle, with a chronic disease, thickening of the membranes. It is somewhat more traumatic than the Winkelmann modification, but it avoids the accumulation of tissues and the unaesthetic appearance of the testicle.
This type of intervention is indicated for congenital hydrocele of the testis in children older than 2 years. The patient is lying on his back.
The doctor after the onset of anesthesia disinfects the inguinal zone and makes an incision in the lower abdomen. This is necessary in order to visualize the spermatic cord and not to touch it during further surgical intervention.
After that, the doctor discovers the vaginal process of the peritoneum, which is the cause of congenital hydrocele. He crosses education and bandages the stump. A hole (“window”) is formed in the inner shell of the testicle.
It is necessary for the outflow of the resulting liquid. After this, stitches and an aseptic dressing are applied. Operation Ross has a fairly large number of varieties.
The technique of its implementation is constantly being upgraded to increase safety and efficiency.
Consequences of the intervention
The following complications are possible depending on the type of operation:
- Hematoma (internal hemorrhage). As a rule, does not require treatment. A hematoma can occur when the sutures are loose.
- Relapse. Minimally invasive methods most often lead to repeated accumulation of serous fluid, if the cause of its formation is not eliminated. Some authors call the relapse rate up to 100%. In operations involving suturing of the testicle, such an accumulation is possible only if a pocket has remained around the parenchyma (loose tissue of the organ).
- Cosmetic defect. Acquired tissue with a strong hydrocele can have an unpleasant appearance of the so-called nodule. This can be avoided by resorting to excision surgery (Bergman). They are more traumatic, but nevertheless advisable when stitching a large area of tissue is required.
- Swelling of the scrotum. It can be observed for several months and is not a cause for concern. The testicles should be soft to the touch.
- Excision of the spermatic cord. Such damage is very dangerous because it leads to infertility. The spermatic cord is practically not recoverable. Crucial is the speed of going to the doctor.
- Testicular atrophy.With this consequence of the operation, the organ gradually decreases in size, its ability to sperm is violated. Atrophy is not subject to treatment, testicular removal is indicated.
Important! You should immediately consult a doctor if the testicle became hard to the touch, increased in size, reddened or acquired a bluish tint.
Recommendations for the recovery period are as follows:
- Wearing loose clothing. It is necessary to abandon swimming trunks and tight boxers. It is advisable for small children not to wear diapers. This is important so that the testicle does not overheat. Important! The exception is puncture hydrocele. In this case, on the contrary, the wearing of tight underpants or a suspensory (supporting bandage) is shown.
- Water procedures can be resumed after 1-2 days. It is preferable to use only a shower for the first time.
- With minor pain, analgesics are indicated. Also, the doctor may prescribe anti-inflammatory drugs.
- Regular monitoring of testicular function and a visit to a urologist are required.
- Lead a healthy lifestyle.
- Abstinence from sexual intercourse for 2-3 weeks.
- Sitting at first is not recommended. It is better to spend several days in bed. The exact date should be indicated by the doctor, depending on the operation.
- If the patient had drainage, then after 2-3 days it is necessary to see a doctor to remove it.
- At home, it is necessary to smear the seam with a solution of diamond greens or anti-inflammatory ointment on the recommendation of a doctor.
Most reviews are left by mothers of children suffering from congenital dropsy. For parents, son surgery becomes a real stress.
Children, as a rule, endure all medical procedures relatively easily and quickly forget them. Dropsy of the testicle in a child sometimes disappears, therefore, mothers who have encountered this, in their reviews, advise not to rush the operation if the doctor does not see a health hazard. The most difficult thing is to entertain the little patient in bed after anesthesia. For some time it is undesirable to get up, and a catheter will be in the boy’s hand. Basically, the prognosis after surgery is favorable. But some mothers write in reviews that they had to go through surgical intervention several times, as the testicle continued to grow in size. Men often leave feedback only if complications arise after surgery: inflammation, relapse. Some adult patients have difficulty diagnosing and choosing the optimal treatment strategy. This is possible due to concomitant diseases - prostatitis, varicocele. In this case, the optimal solution is to contact highly qualified specialists, possibly visiting several doctors. It is necessary to conduct a number of studies, including general ones, a detailed study of the medical history. Surgical intervention can be performed according to the compulsory medical insurance policy or in a private clinic. The average price of operations related to tissue dissection is 10,000 - 30,000 rubles. With bilateral intervention, the cost, as a rule, increases by 60-80%. During the operation, children may increase the price due to the use of general anesthesia. Puncture is the cheapest type of intervention. The price for its holding is from 800 to 3000 rubles. Sclerotherapy will cost 4,000 - 7,000 rubles. Hydrocele surgery can finally solve the problem. With the skillful actions of the surgeon, the likelihood of relapse and complications is minimal. It is important to follow all the doctor's recommendations after the procedure and conduct regular examinations by a urologist. Most cases of pediatric hydrocele do not require special treatment, especially since it rarely comes to surgery.In adults, the situation is reversed, since almost all acquired forms of the disease can not be cured without surgical intervention. There are various hydrocele operations, which depend on the size of the dropsy, the rate of its development, wall thickness and many other factors. The essence of most methods is to eliminate dropsy. In some moments, they turn out to be similar, but nevertheless their advantages and disadvantages remain, as well as special indications for a specific type of operation. With testicular hydrocele, Winkelmann surgery for adults is performed under local anesthesia, and for children it requires general anesthesia. The incision during the operation is made up to 5 cm long. It is located on the scrotum directly above the place where the dropsy bulges. Each layer of tissue, up to the vaginal membrane, is cut separately. When the skin is completely opened and the surgeon gets access to the internal organs, the testicle is excreted into the incision. From the vaginal membrane, where fluid accumulates, everything is pumped out using a special syringe. After that, the cavity is cut. The doctor examines the appendages and the testicle itself. The next step is the plastic shell according to the Winkelman method. First, the shell parts are turned inside out, after which everything is stitched again. Thus, hydrocele after surgery does not form again due to the fact that the fluid produced by the membrane will be absorbed by other tissues. If the hydrocele has a communicating form, then along with the membrane the lumen located in the vaginal process is also sutured. Catgut nodal sutures are used to suture skin areas. Before stitching in the wound, drainage is left so that when a hematoma forms, blood does not accumulate in the scrotum and does not provoke various complications. When the operation is completed, ice is applied to the wound for two hours. During the first 10 days, the sutures dissolve themselves. In the recovery period of hydrocele after Winkelmann surgery, it is recommended to wear a suspensorium. The operation to remove dropsy of the testicle according to the Bergman technique is used at high stages of the disease, when the dropsy grows to large sizes, and its walls thicken. The surgeon finds a place where the enlarged area is located and there, on the scrotum, makes an incision up to 6 cm long. All membranes are cut layer by layer. After this, the testicle is removed to the site of the incision and fluid is pumped out of the dropsy with a syringe. The vaginal membrane is first dissected, and then it is excised by the surgeon. Catgut stitches are placed on what remains of it. After that, the testicle is placed in place and the skin is sutured with the same types of sutures. As in the previous case, drainage is left here and a bubble is left on the wound. After the operation, hydrocele according to Bergman, you need to wear a suspension at the first time. Sutures do not need to be removed, as they resolve on their own within 10 days. This is another traditional type of operation in which a long incision is needed to detect dropsy and gain access to it for the operation. putting the testicle out here may cause any injury. If the operation is unsuccessful. Even if you manage to get rid of dropsy, the vessels inside the scrotum burst, and its tissues are injured. In such conditions, hematomas often form and lymph circulation, blood flow and other processes are disturbed, which can provoke the onset of orchitis or even relapse after surgery. How do dropsy testes work with a high level of security? Safer treatment options are surgery according to the Lord's technique. A scrotum incision is also used here, but unlike the previous options, there is no need to bring the testicle into the wound. This significantly reduces the level of injuries. Due to the fact that the testicle is not excreted, many troubles can be avoided.The vaginal membrane here is simply corrugated after the fluid is sucked and dissected. This operation is not suitable for advanced cases, but in the initial stages it becomes more preferable. Dropsy of the testicle: operation - how to make a puncture Considering how to perform surgery for dropsy of the testicle by puncture, it can be noted that this is one of the easiest ways. Here the needle is immersed in dropsy and all the liquid is sucked out of it. The hydrocele temporarily disappears as the fluid leaves the formation. But over time, it replenishes and the hydrocele returns again. Simplicity here turns into a high probability of relapse, so such an operation is not suitable for treatment, but as a temporary solution to the problem it becomes a very suitable technique. Laparoscopic surgery to remove dropsy of the testis is less traumatic and rarely causes pain syndromes. A short recovery period makes it popular for those who need to quickly return to work, but it has a higher cost. For laparoscopy, several small punctures are made. A camera with a lighting fixture and instruments for surgery are introduced into them. minimal damage to the body creates a minimal risk of complications. The risk of disease return is less than 5%. There are no traces of an incision on the skin. With the appearance of hydrocele before and after surgery, completely different sensations are created in the body, despite the apparent similarity. All pain syndromes are caused by various reasons. The feeling of heaviness is also provoked not by dropsy, but by healing processes. When choosing the right operation, you need to pay attention to: The only way to effectively treat hydrocele in adults is to remove dropsy of the testicle in men. There are cases when even this does not help, but in the end, re-conducting the operation or changing its methodology helps to solve this problem. Surgical intervention can be radical when testicular membranes are used, as well as minimally invasive when minimal surgery is performed. Such procedures in modern medicine can be considered quite simple, although they require special preparation and responsibility in carrying out. Surgery for hydrocele in adults: preparation The preparatory period for the operation is associated with various analyzes. They help to more accurately establish the diagnosis, the presence of complications and the location of the dropsy. It also helps determine the state of health of how the patient undergoes surgery. The methods used to clarify the diagnosis require:
Hydrocele Removal: Surgery
Surgery to remove dropsy of the testicle in men
Dropsy of the testicle in a child sometimes disappears, therefore, mothers who have encountered this, in their reviews, advise not to rush the operation if the doctor does not see a health hazard.
The most difficult thing is to entertain the little patient in bed after anesthesia. For some time it is undesirable to get up, and a catheter will be in the boy’s hand.
Basically, the prognosis after surgery is favorable. But some mothers write in reviews that they had to go through surgical intervention several times, as the testicle continued to grow in size. Men often leave feedback only if complications arise after surgery: inflammation, relapse. Some adult patients have difficulty diagnosing and choosing the optimal treatment strategy. This is possible due to concomitant diseases - prostatitis, varicocele. In this case, the optimal solution is to contact highly qualified specialists, possibly visiting several doctors. It is necessary to conduct a number of studies, including general ones, a detailed study of the medical history. Surgical intervention can be performed according to the compulsory medical insurance policy or in a private clinic. The average price of operations related to tissue dissection is 10,000 - 30,000 rubles. With bilateral intervention, the cost, as a rule, increases by 60-80%. During the operation, children may increase the price due to the use of general anesthesia. Puncture is the cheapest type of intervention. The price for its holding is from 800 to 3000 rubles. Sclerotherapy will cost 4,000 - 7,000 rubles. Hydrocele surgery can finally solve the problem. With the skillful actions of the surgeon, the likelihood of relapse and complications is minimal. It is important to follow all the doctor's recommendations after the procedure and conduct regular examinations by a urologist. Most cases of pediatric hydrocele do not require special treatment, especially since it rarely comes to surgery.In adults, the situation is reversed, since almost all acquired forms of the disease can not be cured without surgical intervention. There are various hydrocele operations, which depend on the size of the dropsy, the rate of its development, wall thickness and many other factors. The essence of most methods is to eliminate dropsy. In some moments, they turn out to be similar, but nevertheless their advantages and disadvantages remain, as well as special indications for a specific type of operation. With testicular hydrocele, Winkelmann surgery for adults is performed under local anesthesia, and for children it requires general anesthesia. The incision during the operation is made up to 5 cm long. It is located on the scrotum directly above the place where the dropsy bulges. Each layer of tissue, up to the vaginal membrane, is cut separately. When the skin is completely opened and the surgeon gets access to the internal organs, the testicle is excreted into the incision. From the vaginal membrane, where fluid accumulates, everything is pumped out using a special syringe. After that, the cavity is cut. The doctor examines the appendages and the testicle itself. The next step is the plastic shell according to the Winkelman method. First, the shell parts are turned inside out, after which everything is stitched again. Thus, hydrocele after surgery does not form again due to the fact that the fluid produced by the membrane will be absorbed by other tissues. If the hydrocele has a communicating form, then along with the membrane the lumen located in the vaginal process is also sutured. Catgut nodal sutures are used to suture skin areas. Before stitching in the wound, drainage is left so that when a hematoma forms, blood does not accumulate in the scrotum and does not provoke various complications. When the operation is completed, ice is applied to the wound for two hours. During the first 10 days, the sutures dissolve themselves. In the recovery period of hydrocele after Winkelmann surgery, it is recommended to wear a suspensorium. The operation to remove dropsy of the testicle according to the Bergman technique is used at high stages of the disease, when the dropsy grows to large sizes, and its walls thicken. The surgeon finds a place where the enlarged area is located and there, on the scrotum, makes an incision up to 6 cm long. All membranes are cut layer by layer. After this, the testicle is removed to the site of the incision and fluid is pumped out of the dropsy with a syringe. The vaginal membrane is first dissected, and then it is excised by the surgeon. Catgut stitches are placed on what remains of it. After that, the testicle is placed in place and the skin is sutured with the same types of sutures. As in the previous case, drainage is left here and a bubble is left on the wound. After the operation, hydrocele according to Bergman, you need to wear a suspension at the first time. Sutures do not need to be removed, as they resolve on their own within 10 days. This is another traditional type of operation in which a long incision is needed to detect dropsy and gain access to it for the operation. putting the testicle out here may cause any injury. If the operation is unsuccessful. Even if you manage to get rid of dropsy, the vessels inside the scrotum burst, and its tissues are injured. In such conditions, hematomas often form and lymph circulation, blood flow and other processes are disturbed, which can provoke the onset of orchitis or even relapse after surgery. How do dropsy testes work with a high level of security? Safer treatment options are surgery according to the Lord's technique. A scrotum incision is also used here, but unlike the previous options, there is no need to bring the testicle into the wound. This significantly reduces the level of injuries. Due to the fact that the testicle is not excreted, many troubles can be avoided.The vaginal membrane here is simply corrugated after the fluid is sucked and dissected. This operation is not suitable for advanced cases, but in the initial stages it becomes more preferable. Dropsy of the testicle: operation - how to make a puncture Considering how to perform surgery for dropsy of the testicle by puncture, it can be noted that this is one of the easiest ways. Here the needle is immersed in dropsy and all the liquid is sucked out of it. The hydrocele temporarily disappears as the fluid leaves the formation. But over time, it replenishes and the hydrocele returns again. Simplicity here turns into a high probability of relapse, so such an operation is not suitable for treatment, but as a temporary solution to the problem it becomes a very suitable technique. Laparoscopic surgery to remove dropsy of the testis is less traumatic and rarely causes pain syndromes. A short recovery period makes it popular for those who need to quickly return to work, but it has a higher cost. For laparoscopy, several small punctures are made. A camera with a lighting fixture and instruments for surgery are introduced into them. minimal damage to the body creates a minimal risk of complications. The risk of disease return is less than 5%. There are no traces of an incision on the skin. With the appearance of hydrocele before and after surgery, completely different sensations are created in the body, despite the apparent similarity. All pain syndromes are caused by various reasons. The feeling of heaviness is also provoked not by dropsy, but by healing processes. When choosing the right operation, you need to pay attention to:
But some mothers write in reviews that they had to go through surgical intervention several times, as the testicle continued to grow in size.
Men often leave feedback only if complications arise after surgery: inflammation, relapse. Some adult patients have difficulty diagnosing and choosing the optimal treatment strategy. This is possible due to concomitant diseases - prostatitis, varicocele.
In this case, the optimal solution is to contact highly qualified specialists, possibly visiting several doctors. It is necessary to conduct a number of studies, including general ones, a detailed study of the medical history.
Surgical intervention can be performed according to the compulsory medical insurance policy or in a private clinic. The average price of operations related to tissue dissection is 10,000 - 30,000 rubles. With bilateral intervention, the cost, as a rule, increases by 60-80%. During the operation, children may increase the price due to the use of general anesthesia.
Puncture is the cheapest type of intervention. The price for its holding is from 800 to 3000 rubles. Sclerotherapy will cost 4,000 - 7,000 rubles.
Hydrocele surgery can finally solve the problem. With the skillful actions of the surgeon, the likelihood of relapse and complications is minimal. It is important to follow all the doctor's recommendations after the procedure and conduct regular examinations by a urologist.
Most cases of pediatric hydrocele do not require special treatment, especially since it rarely comes to surgery.In adults, the situation is reversed, since almost all acquired forms of the disease can not be cured without surgical intervention. There are various hydrocele operations, which depend on the size of the dropsy, the rate of its development, wall thickness and many other factors.
The essence of most methods is to eliminate dropsy. In some moments, they turn out to be similar, but nevertheless their advantages and disadvantages remain, as well as special indications for a specific type of operation.
With testicular hydrocele, Winkelmann surgery for adults is performed under local anesthesia, and for children it requires general anesthesia. The incision during the operation is made up to 5 cm long. It is located on the scrotum directly above the place where the dropsy bulges. Each layer of tissue, up to the vaginal membrane, is cut separately. When the skin is completely opened and the surgeon gets access to the internal organs, the testicle is excreted into the incision. From the vaginal membrane, where fluid accumulates, everything is pumped out using a special syringe. After that, the cavity is cut. The doctor examines the appendages and the testicle itself. The next step is the plastic shell according to the Winkelman method. First, the shell parts are turned inside out, after which everything is stitched again.
Thus, hydrocele after surgery does not form again due to the fact that the fluid produced by the membrane will be absorbed by other tissues. If the hydrocele has a communicating form, then along with the membrane the lumen located in the vaginal process is also sutured. Catgut nodal sutures are used to suture skin areas. Before stitching in the wound, drainage is left so that when a hematoma forms, blood does not accumulate in the scrotum and does not provoke various complications. When the operation is completed, ice is applied to the wound for two hours. During the first 10 days, the sutures dissolve themselves. In the recovery period of hydrocele after Winkelmann surgery, it is recommended to wear a suspensorium.
The operation to remove dropsy of the testicle according to the Bergman technique is used at high stages of the disease, when the dropsy grows to large sizes, and its walls thicken. The surgeon finds a place where the enlarged area is located and there, on the scrotum, makes an incision up to 6 cm long. All membranes are cut layer by layer. After this, the testicle is removed to the site of the incision and fluid is pumped out of the dropsy with a syringe. The vaginal membrane is first dissected, and then it is excised by the surgeon. Catgut stitches are placed on what remains of it. After that, the testicle is placed in place and the skin is sutured with the same types of sutures. As in the previous case, drainage is left here and a bubble is left on the wound. After the operation, hydrocele according to Bergman, you need to wear a suspension at the first time. Sutures do not need to be removed, as they resolve on their own within 10 days.
This is another traditional type of operation in which a long incision is needed to detect dropsy and gain access to it for the operation. putting the testicle out here may cause any injury. If the operation is unsuccessful. Even if you manage to get rid of dropsy, the vessels inside the scrotum burst, and its tissues are injured. In such conditions, hematomas often form and lymph circulation, blood flow and other processes are disturbed, which can provoke the onset of orchitis or even relapse after surgery.
How do dropsy testes work with a high level of security?
Safer treatment options are surgery according to the Lord's technique. A scrotum incision is also used here, but unlike the previous options, there is no need to bring the testicle into the wound. This significantly reduces the level of injuries. Due to the fact that the testicle is not excreted, many troubles can be avoided.The vaginal membrane here is simply corrugated after the fluid is sucked and dissected. This operation is not suitable for advanced cases, but in the initial stages it becomes more preferable.
Dropsy of the testicle: operation - how to make a puncture
Considering how to perform surgery for dropsy of the testicle by puncture, it can be noted that this is one of the easiest ways. Here the needle is immersed in dropsy and all the liquid is sucked out of it. The hydrocele temporarily disappears as the fluid leaves the formation. But over time, it replenishes and the hydrocele returns again. Simplicity here turns into a high probability of relapse, so such an operation is not suitable for treatment, but as a temporary solution to the problem it becomes a very suitable technique.
Laparoscopic surgery to remove dropsy of the testis is less traumatic and rarely causes pain syndromes. A short recovery period makes it popular for those who need to quickly return to work, but it has a higher cost. For laparoscopy, several small punctures are made. A camera with a lighting fixture and instruments for surgery are introduced into them. minimal damage to the body creates a minimal risk of complications. The risk of disease return is less than 5%. There are no traces of an incision on the skin.
With the appearance of hydrocele before and after surgery, completely different sensations are created in the body, despite the apparent similarity. All pain syndromes are caused by various reasons. The feeling of heaviness is also provoked not by dropsy, but by healing processes. When choosing the right operation, you need to pay attention to:
The only way to effectively treat hydrocele in adults is to remove dropsy of the testicle in men. There are cases when even this does not help, but in the end, re-conducting the operation or changing its methodology helps to solve this problem. Surgical intervention can be radical when testicular membranes are used, as well as minimally invasive when minimal surgery is performed. Such procedures in modern medicine can be considered quite simple, although they require special preparation and responsibility in carrying out.
Surgery for hydrocele in adults: preparation
The preparatory period for the operation is associated with various analyzes. They help to more accurately establish the diagnosis, the presence of complications and the location of the dropsy. It also helps determine the state of health of how the patient undergoes surgery. The methods used to clarify the diagnosis require:
- Blood biochemistry
- General analysis of urine and blood,
- Research on HIV infections, hepatitis and so on,
- Clinical blood test, which shows the ability to coagulate and other parameters important for the operation,
- Bypassing doctors to determine chronic diseases,
- Therapist consultation.
Right before the operation, the patient needs to take a shower, shave the scrotum and pubis.If the operation is performed in children, then they may need to stay overnight, and adults can leave the hospital a few hours after the operation.
Dropsy testicle operation as in an adult
For adult men, there are several types of surgical techniques that are designed to solve the problem of hydrocele. In almost all of them, it is required to eliminate the liquid from dropsy with a special syringe, and after that it is already necessary to process the membrane according to a separate technique in order to prevent further hydrocele. If this is not done, then there is a chance of a return of the disease. This is clearly seen on the example of puncture, when in almost all cases a relapse occurs. The following operations are known:
After surgery, dropsy testicles in men
After the operation, the patient needs to spend several hours in the hospital. Often, a wound that is still under local anesthesia is applied for 2 hours.
Dropsy of the testicle in men: operation photo
After surgery, photos of dropsy of the testicle in men may display some of its effects. Over time, they should disappear, but sometimes there are various complications. These complications include:
- The appearance of a hematoma. No matter how doctors try to avoid it, sometimes it takes on a serious scale.
- A rough scar. Despite the special sutures, in some cases the wound heals so that the scars stick out too much.
- Relapse. It is unlikely, but still likely, that the disease will return for some reason.
- Swelling of the scrotum. If the testes remain soft, then it does not cause problems and can go away for several months. A hard surface may indicate more serious problems.
- Testicular atrophy. A serious consequence that needs to be tracked in a timely manner so that it does not become irreversible.
Congenital dropsy of the testicles
The testicle is initially laid in the retroperitoneal space with subsequent migration to the scrotum due to the Hunter cord, the vaginal process of the peritoneum and the influence of sex hormones. After dropping, the circular fibers of the muscle raising the testis (m. Cremaster) block the serous tube. As a result, a connective tissue cord is formed.
A channel is formed connecting the scrotum cavity and the abdominal organs.
With insufficient closure, a channel forms that connects the scrotum cavity and abdominal organs, which leads to the development of dropsy of the testis in men (hydrocele) or inguinal hernia.
Partial obliteration of the process leads to isolated changes in the type of testicular cysts or dropsy of the spermatic cord.
The physiological dropsy of the testis in newborns due to increased fluid formation and insufficient excretion is considered. It disappears on its own without treatment by the first year of the baby's life.
Testicular hydrocele: surgery, types of surgical intervention
Dropsy on the testicle appears in men in adulthood, but it is often found in young boys. The problem occurs after trauma to the penis, as a result of transferred infectious and inflammatory diseases. Inadequate outflow of lymph in the inguinal region leads to the appearance of hydrocele.
Dropsy in children and inguinal hernia is a consequence of intrauterine disturbance. And if doctors are in no hurry to treat infants, then with hydrocele of the testicle, surgery in boys after 2 years and in adult men helps to avoid complications.
Surgical intervention protects against the spread of the pathological process to the vas deferens.
An epithelial watery mass accumulates inside the membrane of the reproductive organ.
Its volume is from a few milliliters to a liter or more. The accumulation of fluid provokes an increase in size, swelling of the scrotum on one or two sides. With hydrocele, pain does not always appear, often treatment is not required.
The surgeon's help is needed when the discomfort, edema does not disappear on its own in 1.5-2 months or after a course of conservative therapy. Depending on the severity of the edema, a minimally invasive operation is performed by the puncture method or radical intervention is prescribed.
Objective signs with dropsy of the testis depend on the form and causes that led to the development of the disease. Chronic dropsy, non-inflammatory in nature manifests itself:
- an increase in the volume of the scrotum,
- lack of pain.
Against the background of dropsy, the shape of the scrotum changes. In the case of fluid accumulation in the lower pole - pear-shaped deformation. If the liquid component accumulates not only in the scrotum, but also in the inguinal canal, then the shape resembles an hourglass.
With an infectious nature, dropsy is accompanied by:
- acute pain
- elevated temperature
- pronounced unilateral or bilateral enlargement of the scrotum.
With an infectious nature, dropsy is accompanied by acute pain during urination.
In the absence of a previous injury or inflammation, complications are extremely rare with hydrocele. Violations of the reproductive function of the disease practically does not happen, since it does not affect the quality and quantity of seminal fluid.
But there is a risk of atrophic changes due to increasing edema and vascular compression.
The diagnosis includes a complete physical examination in horizontal and vertical position, a survey with a clarification of a possible cause, instrumental studies.
A diaphanoscopy technique is used to determine the nature of the liquid contents. It is based on the ability of various media to transmit light beams. If the scrotum is filled with transudate, then in a dark room it will have a reddish hue. While the dense high-protein (purulent) component is not visible.
The most informative is considered an ultrasound scan (ultrasound), which allows to assess the amount and nature of the fluid, changes in local blood supply, to exclude traumatic damage to the soft tissues.
For the correct diagnosis, a painless ultrasound of the scrotum is used.
To exclude infectious diseases, the urologist will prescribe a laboratory diagnosis - a blood test, urine test.
The tactics of treatment of testicular hydrocele are determined by the surgeon depending on the age of the patient, the general somatic state and the causes of the disease.
For children with a congenital form, wait-and-see tactics prevail with monitoring of clinical manifestations until the age of 1 year is reached. Preservation of severity is a direct indication for surgical intervention.
In the presence of dropsy in adult men, in most cases, surgery is used. An exception is the inflammatory cause of dropsy. Treatment then is based on a conservative approach using drugs.
Types of surgical intervention for hydrocele
There are several options for the correction of testicular hydrocele. The choice is based on the age of the patient, the amount of accumulated fluid and somatic health indicators.
Wilkelmann operation. Carrying out using anesthesia (general or local). Equipment:
- An incision is made along the anterior surface of the scrotum.
- Extraction of the testis.
- Evacuation of fluid.
- The testicle shells are dissected, turned and stitched.
- Suturing, then installing drainage.
To reduce swelling after manipulation, a cold compress is applied.
Bergman operation. It is used for large accumulations of fluid. The technique is similar to the Wilkelmann technique. Differs in the absence of eversion of testicular tissue. Also install drainage, which is removed after removal of the seams.
Operation Lord. They resort to this technique in the case of:
- moderate amount of fluid
- if the patient has spontaneous bleeding, the risk of thrombosis.
A more gentle approach due to the incision along the pouch.
If there is no possibility of carrying out surgical intervention according to classical methods, puncture is used. It is also prescribed in the case of the development of repeated postoperative hydrocele. Contraindication for piercing with dropsy is an acute infection, accompanied by an increase in body temperature and a sharp pain syndrome.
Hydrocele: how is the operation
Hydrocele surgery is mandatory if it is found in adults. Over the entire period of treatment of the disease, several surgical procedures have been developed. New experimental operations are also now appearing, but proven traditional methods are still used for treatment. With dropsy of the testicle, the course of the operation in many cases is the same and differs only in crosslinking features.
Dropsy of the testicle: how is the operation
After all preparation procedures, during which it is necessary to remove the strip from the places where the operation will be performed, the patient is given local anesthesia. When it begins to act, the surgeon determines the place of the future incision and treats it with alcohol. After this, the tissues on the scrotum begin to intersect. The length of the incision is about 5 cm. This is done in layers, since otherwise it is possible to damage any areas, which will affect the functionality of the organs in the future.
Having reached the last layer, the scrotum is opened and the surgeon gets access to the internal organs. The testicle is removed into the wound and fixed. Then, with the help of a special syringe, the needle of which is inserted into the dropsy, all the liquid is sucked out of it. Thus, the hydrocele is eliminated and, on the one hand, we can assume that the disease is no longer there. But if you do not manipulate the shell in which it formed, then there is a chance of a return.
There are the following options for hydrocele, how the operation goes:
- The shell is cut and turned inside out, then stitched again,
- The shell is cut and the remains are sutured,
- The shell is corrugated
- The shell does not move (a high probability of relapse).
When all manipulations with the membrane are completed, then the doctor proceeds to suturing the wound. For this, various types of seams are used. In almost every such intervention, rubber drainage is left, which will prevent the accumulation of blood and the formation of a hematoma. After the last stitches have been applied, the patient is put ice for two hours. At this time, he departs from anesthesia and in a few hours can leave the hospital.
This type of intervention is considered as a temporary way to improve the condition when radical surgery is impossible. Usually the effect lasts about six months.
The doctor injects the anesthetic into the puncture site. After that, he punctures the testicles with a thin needle and sucks out the liquid. The puncture is sealed with a sterile adhesive.
Dropsy of the testicle: how long does the operation
The duration of the operation is 30-40 minutes. This includes dissecting several layers of tissue, pumping fluid out of dropsy, manipulating the membrane in which the fluid was located, stitching the tissues, and installing drainage. Differences of 10 minutes, both up and down, are quite normal.
A much longer process is the expectation of withdrawal from anesthesia. After completing the procedure, the patient needs to stay in the hospital for a few more hours. As soon as everything is stitched, then on the operated site you need to attach for 2 hours. This should protect against hematomas and other complications. After the ice is removed from the operated site, the doctor still has to examine the results before the patient can go home.In total, after the operation, it may take another 3-4 hours.
How long does the testicular dropsy operation in a child and adult last and what does it affect
There is no big difference between the duration of the operation in children and adults. On the one hand, dropsy is often smaller in children, which reduces the time it takes to drain the fluid, and on the other hand, a more delicate attitude is required during the procedure. The following factors influence the time how long the hydrocele operation lasts:
- The methodology of the procedure, in which certain differences in operations can lengthen the process of their implementation,
- The size of the dropsy with which the surgeon has to spend more time with prolonged pumping of the liquid,
- The thickness of the walls of the shell, which with large sizes are more difficult to manipulate,
- The experience of a surgeon, which allows you to carry out many actions faster,
- The use of local or general anesthesia, in which the time of input and output of the patient from it is very different.
In any case, the amount of time spent on the operation for the patient should not be of great importance. Its recovery period and success are much more important, since with a quick but ineffective treatment procedure, hydrocele will return.
Dropsy of the testicle: the consequences of surgery
After the end of the treatment procedure, it is too early to talk about any major changes. The first days and weeks may not be noticeable, since there is a recovery period, the wounds heal and various processes occur that naturally appear after surgery. The presence of consequences can only be said after a recovery period, excluding acute manifestations.
With dropsy of the testicle, the consequences after surgery may look like this:
- The formation of a hematoma. After any surgery, this phenomenon may occur. But if it does not pass during the first weeks, then this already becomes a serious negative consequence. A hematoma leads to the accumulation of blood in certain places, which provokes stagnation and can become the beginning of necrosis and tissue rejection, decay and other unpleasant processes.
- Piocele A very serious negative phenomenon, which is associated with suppuration of the inner shell of the testicle. During surgery, tissues of the internal organs often suffer and may be partially damaged. This periodically leads to their necrosis and rotting inside. This consequence can entail a host of other phenomena that will entail infertility, atrophy, and the need for amputation.
- Relapse. During traditional operations, its probability is small, but the chance always remains, since there is a human factor, possible undetected health problems and other causes. As a rule, dropsy returns in the same place where it was before, but there are cases in which it appears in the other half of the scrotum. If the return of the hydrocele, the consequences of the operation require its repeated implementation. After this, the chances of relapse are further reduced.
- Divergence of seams. During the first ten days, the seams should come off on their own, since now absorbable options are mainly used. But it may happen that during this period due to severe overstrain and failure to comply with the recommendations of doctors, the wound will open even before everything is fused. Often, there is no fault of the doctor and only excessive activity of the patient leads to the formation of such problems. You must carefully adhere to all recovery rules.
- Infection. Infections can get into the wound, both during the operation and after it. They do not appear immediately, but over time, which leads to negative consequences when a man recovers from surgery.Such effects of hydrocele are required to be treated with medications, most often antibiotics.
- Inflammation and swelling. With hydrocele, surgery, the consequences can lead to swelling. If this goes on for several days, and then everything goes off, then the case should not be given special significance. With prolonged swelling, problems may already occur. You need to contact a specialist to solve the problem and diagnose what exactly leads to the appearance of swelling and inflammation.
Various phenomena in the form of discomfort, pain and other things, although it can be attributed to the consequences of the operation. But all this has a temporary effect and is inherent in almost any type of surgical intervention, and not just treatment of hydrocele. With dropsy of the testicle in men, the consequences after surgery most often occur if the patient has violated the restrictions on recovery. The consequences are quite rare and most of them are due to the carelessness of the patient. To avoid them, you need to regularly visit a specialist to monitor recovery.
Dropsy of the testicle: the cost of the operation
Prices for the operation depend on the clinic where it is performed, so that even within the same city certain differences may arise. On average, the following data can be given:
- Operation according to the Ross method - from 14 thousand rubles,
- Operation according to the method of the Lord - 23-27 thousand rubles,
- Operation according to the Winkelman technique - 11-20 thousand rubles (due to the prevalence in many places, the price spread is quite high),
- The operation according to Bergman’s technique is 15-25 thousand rubles (a more complicated procedure, but, as in the previous case, its prevalence affects the price spread.
Testicular dropsy operation: prices in St. Petersburg
In large cities, the cost of operations is usually higher. Many factors influence this, but the trend almost always remains the same. Moreover, in them you can find a greater variety of types of procedures, since innovative technologies and those methods that require more modern equipment that are not available in other clinics are more often used. Considering how much a hydrocele operation costs in St. Petersburg, the following data can be distinguished:
- Bergman operation - 27.5 thousand rubles,
- Winkelman operation - 25.5 thousand rubles,
- Operation on the Lord - 16 thousand rubles.
Surgical treatment for testicular dropsy
Boys under the age of one and a half years with hydrocele are prescribed treatment with conservative drugs. But for older children and men, surgery is needed. There are several surgical techniques. In each individual case, the operation for dropsy of the testicle in men is selected individually.
Intervention in adults is carried out under local anesthesia. With dropsy of the testicle in children, general anesthesia is required. 30-40 minutes before the start of the operation, do sedation - sedatives are administered. Then they begin to manipulate.
The operation according to the method of Ross is mainly prescribed to boys after 2 years with congenital communicating dropsy of the testicle. This type of surgical treatment is also used, and in cases when an infection occurs, the volume of liquid contents rapidly increases.
In children, Ross surgery is performed under general anesthesia. The child lies on his back. After the start of anesthesia, the doctor disinfects the surgical field, makes an incision in the lower abdomen. This allows you to see the spermatic cord and not damage it with further manipulations.
During the operation according to the Ross technique, the doctor must find the parietal pocket of the peritoneum, cross it and bandage it.
To drain the fluid, the surgeon makes a small hole in the testicle. Upon completion of all necessary manipulations, the doctor imposes an external suture, closes the surface with a sterile dressing.
Ross operation requires a specialist to be fully concentrated. If during the intervention the surgeon permits negligence, adjacent anatomical structures may suffer. Therefore, an unsuccessful Ross operation with dropsy of the testicle can lead to irreparable consequences.
Treatment according to the Lord’s technique is considered the least traumatic surgical treatment for dropsy. The fluid is removed through a small incision (the length does not exceed 4 cm) in the pouch and membranes of the testis.
After that, the testicle is pushed through the incision, the doctor checks how correctly it is placed, whether there are any injuries or pathologies of the gonad. The surgeon collects the sheath of the vagina along the entire perimeter, fixes it with absorbable threads.
The egg is returned to its original place. The wound is sutured in layers, covered with a bandage.
In most cases, recovery after surgery takes place without serious complications and lasts up to 1 month. A few hours later, after the procedure, the man can leave the clinic. Children are most often left in the surgery department for a day.
When the anesthetic is stopped, pain may occur. To remove it, doctors recommend taking analgesics or non-steroidal anti-inflammatory drugs. Additionally, a course of antibiotics is prescribed to the patient.
If the operation to remove dropsy of the testicle is performed with the installation of drainage, then you will have to visit the clinic 2-3 days after discharge. The doctor will remove the tubes, and the postoperative sutures will be removed on the 7-10th day.
In order for treatment of testicular dropsy to be successful, you must strictly follow the doctor's recommendations at home:
- do not wet the wound in the first 3 days after surgery, hygiene procedures in the shower are later permitted,
- treat the seam with a solution of brilliant green, anti-inflammatory ointments,
- do not sit for a week after the intervention, walk as little as possible,
- until full recovery, do not strain the muscles of the peritoneum, do not lift weights,
- have sex no earlier than 5-6 weeks after the stitches are removed.
Urologists advise after surgery to heal dense underwear until the wound heals, and babies should not wear diapers. But if the aspiration of the fluid was carried out using puncture, then you will have to wear tight underpants or a special bandage.
After the operation, a digestive system malfunction may occur. Most often, it manifests itself as constipation, which after a few days passes. To avoid such a nuisance, it is worth eating light foods rich in plant fiber.
Adverse Effects of Surgery
Postoperative complications in men are rare. They are associated with the features of the intervention or with the individual reaction of the body.
Complications of the early postoperative period are associated with infection of the wound, the development of inflammation. If the patient does not comply with bed rest, soon after the intervention heights, the stitches may break.
Swelling and stagnation of the lymph are more common than other complications. They almost always go away without treatment. If the seams are loosely applied, hemorrhage may occur, but the bruise resolves on its own.
A man needs to seek help as soon as possible if after the operation the testicle has become hard, swollen, a red or bluish tint is noticeable.
After minimally invasive interventions, repeated dropsy sometimes occurs. Doctors explain this by the fact that with sclerosis or puncture the cause of the problem is not eliminated. The operated organ does not always look attractive. The scrotum takes the form of nodule, if the doctor has to suture a large surface.
In order not to miss the pathology of the development of the genital organs, boys should be regularly shown to a pediatric surgeon.Adult men who notice swelling of the scrotum should not rely on recipes and reviews from the Internet. It is better to immediately consult a urologist.
Causes of testicular dropsy in men
It should be noted that the mechanism of development of the disease in question is not fully understood. But it is well known that the accumulation of fluid in the saccular space occurs due to the absence (or difficulty) of the outflow of this same fluid. In turn, there are several factors that contribute to the violation of the outflow:
- testicular injury
- swelling of the lower extremities and closely located organs, regardless of the causes of their occurrence,
- infectious diseases,
- benign / malignant tumors of the testis.
These conditions lead to blockage of the excretory ducts - they are responsible for the timely and full outflow of fluid from the saccular space. Separately, it is worth mentioning the risk factors for the development of dropsy of the testicle in men:
- surgical treatment in the perineum,
- conducting radiation therapy, with a direct impact on the area of the male genitalia,
- pathological changes in the congenital or acquired nature of the duct that connects the abdominal cavity to the scrotum.
Symptoms of dropsy in men
The clinical picture with the development of the disease in question is characterized by low intensity - the symptoms are practically absent. In very rare cases, fluid accumulation in the scrotum is spasmodic - for example, if there are acute inflammatory diseases or the patient is in the early postoperative period.
Pronounced symptoms appear only with too large testicles - they can reach more than 10 cm in diameter. And then the patient will complain about:
- difficulty urinating
- inability to walk normally
- constant feeling of heaviness in the scrotum,
- discomfort, in rare cases - pain, during sex,
- high density scrotum,
- clear perception of splashing fluid in the scrotum during palpation of the testicles,
- inability to determine the contour of the testis.
If dropsy of the testicle in men is accompanied by a serious infectious disease, then the accumulated exudate in the saccular space of the scrotum becomes purulent. A similar condition is classified in medicine as a complication of dropsy of the testicle and is called piocele. With this development of the disease, the following symptoms will be noted:
- increase in body temperature to critical levels,
- the general well-being of the patient deteriorates sharply - there is weakness, drowsiness, dizziness,
- the inflammatory process extends to closely located tissues.
In the absence of adequate treatment, piocele can lead to the following problems:
- violation of reproductive function - there is a squeezing of blood vessels located in the scrotum, which leads to atrophy of the testicle,
- hematocele - accumulation of exudate with blood in the saccular space against vascular injury,
- rupture of the testicle shells - due to overstretching of their walls by accumulated liquid,
- scrotal hernia progression.
Drug treatment of hydrocele in men
In the case of diagnosing an infectious or inflammatory disease in a man against dropsy of the testicle, the therapy will be aimed specifically at curing it. In general, doctors believe that getting rid of the cause of hydrocele, you can do without surgical intervention. As part of the medical treatment of dropsy of the testicle in men, the following can be used:
- antibacterial drugs (antibiotics),
- non-steroidal anti-inflammatory drugs,
- blood circulation normalizing agents.
Surgical treatment - operations for hydrocele in men
Surgery is used only in case of failure of therapeutic treatment.In medical institutions, two methods of surgical intervention are used:
Hydrocelectomy. It is performed under regional anesthesia, an incision is made along the scrotum or lower abdomen, the doctor assesses the condition of the canal between the abdominal cavity and the scrotum, and the hydrocele itself is removed.
Please note: in the postoperative period, the patient is set to drainage - this is the prevention of postoperative dropsy of the testicle (relapse). Drainage is removed a few days after surgery - this period is set individually.
Topically applied cold to reduce postoperative edema.
Please note: this method of surgical treatment is used extremely rarely, as their low / short effectiveness is noted. Puncture aspiration of the fluid is carried out only with obvious contraindications to a full-fledged surgery with anesthesia.
The danger of puncture aspiration of the fluid lies in the high risk of developing infection of the puncture site and bleeding. But with hydrocelectomy, the doctor personally controls the location of the incision, and its size, and all the work inside the patient’s body.
The postoperative period in the treatment of dropsy of the testicle in men is practically absent - the patient immediately after the operation is placed in a ward to monitor his well-being and the work of all organs and systems.
The discharge is carried out (with successful recovery) on the day of surgery - the patient is given recommendations on an outpatient basis.
The patient must perform a follow-up visit to the doctor in a few weeks - the doctor examines the wound, excludes its infection and recurrence of testicular dropsy.
Alternative treatment of dropsy of the testicle
Diagnosis of the disease in question involves the implementation of therapeutic treatment. And if the patient's condition does not yet need urgent surgical care, then alternative methods can be used for treatment. Of course, a man should consult with his doctor, get permission to use any specific recipes.
Tincture of clover meadow.
It is necessary to take 200 g of fresh flowers of the plant or 100 g of dry flowers, pour 2 liters of dry wine (you can use both white and red) and insist for a week, periodically thoroughly shaking.
Then the mixture is boiled over medium heat for 3 minutes, turned off and cooled in natural conditions (without putting the vessel out in the cold). An infusion of 50 ml is taken three times a day before meals.
Corn silk. Mixes honey with corn stigmas (dry or fresh) in a 2: 1 ratio. The mixture is consumed in 1 teaspoon three to five times a day.
Nettle. Only the roots of the plant are used, which are brewed like ordinary tea (a teaspoon of dry raw materials per glass of boiling water) and consumed as a drink (up to 500 ml per day).
Treatment of dropsy of the testicle in men with folk remedies lasts a long time, for a couple of receptions of the above mixtures, health can not be returned. But you need to take breaks in the courses - for example, 1 month to take the daily selected remedy, then 5 days - a break.
Dropsy testicles in boys
This disease in childhood does not belong to the category of dangerous, but it is impossible to hesitate with treatment - it is necessary to maintain the childbearing function of the boy. In childhood, dropsy of the testicle can occur in two forms:
- isolated hydrocele - fluid accumulates in a localized space,
- communicating hydrocele - the exudate is not in a constant state, it pours from the abdominal cavity into the testicle.
Please note: pediatricians claim that the communicating type of the disease in question is more dangerous than isolated, because it contributes to the formation and progression of inguinal hernia. But this pathology is already quite serious and requires emergency surgical intervention.
Symptoms of children's hydrocele
The main signs of dropsy in boys are an enlarged scrotum and the absence of any pain. If there is an isolated hydrocele, then an increase in the scrotum in size will be observed constantly. In the case of the development of a connecting hydrocele, the scrotum returns periodically to its normal size, and after a while - an increase.
The principles of treatment of dropsy of the testicle in childhood
Actually, the treatment of the disease in progress in childhood is absent. According to statistics, in 80% of cases, hydrocele in childhood passes immediately after tightening the inguinal ring (this is a natural process), and in 10% of cases, such a disease is generally not recognized as a pathology.
Dropsy of the testis in both boys and men is not a dangerous / serious disease. But it is impossible to ignore it - some complications that negatively affect the patient’s life still exist. Only well-chosen therapy, timely prescribed surgical treatment will preserve the male reproductive function and the general standard of living.
- Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category
Complications after surgery
When all the recommendations of the attending physician are followed, the operation to eliminate hydrocele is rarely accompanied by complications.
Perhaps a slight increase in temperature, persisting several days after manipulation. This is a natural reaction of the body to the intervention. But if it persists for a long time, it is necessary to inform the doctor about this.
Perhaps a slight increase in temperature, persisting several days after surgery.
If the specified bed rest is not observed and the early transition to active activity, the seams can separate. Then urgently need to see a doctor.
Hydrocele therapy without surgery will be effective in infectious genesis. Then prescribe antibiotic therapy. To reduce inflammation - non-steroidal anti-inflammatory drugs.
If necessary, supplement the course of treatment with drugs to improve blood flow and normalize lymphatic drainage.
Rehabilitation lasts for a month, but may be longer if there is a concomitant pathology. The area of operative access is covered with a sterile dressing with daily surface treatment with chlorhexidine or potassium permanganate.
After a week, they begin to remove the stitches.
Postoperative sutures can be removed in a week.
For proper healing of the wound surface, it is necessary:
- observe bed rest during the first days,
- exclude weight lifting to prevent seams from diverging,
- do not go to baths and saunas for a month,
- use ph-neutral agents for showering,
- wear a support brace to prevent relapse,
- limit sex life to 6 weeks after manipulation.
In addition, the doctor can recommend a course of physiotherapy, massage to activate recovery processes.
Diet is of great importance in the recovery period. It is necessary to exclude fatty, spicy, canned, heavy food, alcohol. Add porridge, soups based on low-fat broth, dietary varieties of meat, fish to the diet.
Thus, today hydrocele is diagnosed in the early stages thanks to modern approaches, and, accordingly, is successfully treated. The appearance of pain, severity, discomfort in the testicles - a signal of the need to seek medical help.
Dropsy of the testis in a child and a man: causes and treatment in boys and adults
- Urologist andrologist of the 1st category Pyotr Viktorovich
- Update Date: November 2019
Dropsy of the testicle (hydrocele) is a disease caused by the accumulation of serous fluid between the membranes of the organ.Pathology manifests itself as a noticeable increase in the size of the testicle, pain is most often absent. Dropsy is treated mainly by surgery, the operation is safe and takes no more than half an hour.
About the disease: features and prevalence
A detected ailment in young children may eventually disappear on its own
Dropsy can hardly be called a rare disease, it occurs in 1% of men. Dropsy of the testicle is both congenital and acquired.
Dropsy of the testicle in the ICD-10 is indicated by codes N43.0-N43.3, the exact designation depends on the specific course of the disease.
The congenital form is most often diagnosed in the first year of life. Dropsy of the testicles in newborns does not always need to be treated. Quite often, the pathology goes away by itself, by about 3 years. However, this does not exclude regular medical supervision and preventive measures.
In adult men, the disease most often has a traumatic nature, that is, it develops after bruises and strokes in the scrotum.
As a rule, with dropsy of the testicles in boys and adult men, only one organ is affected, respectively, only one testicle increases. This process is called unilateral dropsy.
The bilateral form is very rare and can occur as a complication after surgery.
The main symptom of dropsy of the testicle shells is severe edema and organ enlargement. The severity depends on the stage of development of hydrocele.
Light forms may not make themselves felt for many years, in advanced cases, dropsy becomes gigantic - the testicle can be the size of a child’s head or larger.
The largest tumor that was surgically removed consisted of more than three liters of fluid.
Fall can easily become a catalyst for the appearance of pathology
Having figured out why dropsy of the testicles occurs in men and children, and what reasons contribute to this, before studying treatment methods, you should understand the mechanism of development of this disorder. It depends on the type of disease.
With physiological dropsy, fluid accumulation occurs due to an incompletely closed opening between the peritoneum and scrotum. For the same reason, inguinal hernias develop in childhood.
With traumatic dropsy, fluid accumulation is a consequence of a malfunction of the lymphatic vessels. The body tries to protect the testicles from possible injuries by increasing the amount of fluid in the scrotum.
In general, these are only assumptions, because the pathogenesis of testicular dropsy in children and adults has not yet been accurately studied.
Classification and types
Due to the development, they distinguish between congenital (physiological), secondary and idiopathic dropsy. Inborn form is encountered by boys in the first years of life. Secondary pathology is called, arising as a complication of any disease and condition. Among them:
- congestive heart failure,
- pathology of the lymphatic system,
- inflammation of the lymph nodes in the groin,
- inflammation of the testicle and its appendage,
- injuries and bruises
- sexually transmitted infections.
Postoperative fluid accumulation between testicular membranes is also called secondary dropsy.
An idiopathic form of pathology is called, the obvious reasons for the development of which are either absent or simply cannot be identified by a comprehensive examination.
This is exactly the case when a man did not have diseases, injuries or operations, but suddenly the testicle increased in size and dropsy developed. In general, the idiopathic form is no different from other types of pathology, except for the causes of development, therefore it is successfully treated.
True, with this form, the risk of relapse remains if full surgical treatment has not been carried out.
The location of fluid accumulation distinguishes three forms of the disease:
- not communicating dropsy,
- hydrocele of spermatic cord.
In the first case, the fluid stagnates on both sides and flows freely in the scrotum. Non-communicating dropsy is an accumulation of fluid in only one testicle. Also, the disease can occur in the spermatic cord, as a rule, this occurs as a complication of epididymitis.
Hydrocele: operation and price
Pricing factors are very important when choosing a location and type of operation. They help explain why the cost of the procedure is higher in one place than in others. One of the main pricing factors is the type of operation. The complexity of the operation increases its price, since the doctor has more responsibility, he needs more time to carry out the procedure, not to mention the use of any additional means or tools. This is entirely due to the difference of 5-10 thousand rubles when carrying out different procedures in the same clinic.
During testicular hydrocele, the cost will depend on the location of the clinic. This is not only a city, since in regional centers prices are higher than in other cities, but in developed settlements, in particular in the capital, all this becomes even more expensive. Here, the location of the clinic in the city itself plays a role. Central medical institutions charge a large fee for the operation. With hydrocele, it does not have very big differences, since there is no need for a hospital. But if you need to stay in the clinic in a few days, the price would increase much more.
Dropsy of the testicle: operation, cost
When treating dropsy of the testicle, the cost of the operation also includes all the medicines necessary for its implementation, such as anesthesia, disinfection, etc. The more they are used, the more expensive the operation will be. Also here is the type of medication itself, stitching threads and other things. All of them are produced by various companies with different quality, so in the total amount this can significantly affect the prices.
The category of operations can significantly increase the cost of the operation. The more complex the case, the higher the required category. They differ in the size of the formed dropsy and the presence of complications caused by the disease. For example, during a Bergman operation, category 1 may cost 15, the second category - 20, and the third category - 25 thousand rubles. A similar trend persists for other surgical techniques.
The need for general anesthesia. In most cases, the cost of local anesthesia is included in the operation. If the patient needs general anesthesia, for any reason, then the price of the procedure becomes 2-5 thousand higher, depending on the anesthesia itself and the venue.
The experience of the doctor and the general staff at the clinic also play a role in price formation. This is more common in private clinics when experienced surgeons begin their own medical practice. In well-known hospitals with experienced surgeons, the rates are higher, since they are also often visited by a large flow of patients who are confident in the quality of services and create higher tariffs for their provision.
Used equipment. The technique in medicine is constantly evolving, as it moves the progress of treatment methods, increases the safety of operations and so on. Modern equipment is more expensive, so in the clinics where it is installed, the price for operating dropsy testicles in men will be much higher. This is justified by the fact that all equipment must pay off. The patient is more confident in the safety and effectiveness of treatment, and it becomes easier for doctors to work on new modern technology. Therefore, in municipal institutions, prices are often much lower.
Hydrocele operation: compulsory medical insurance
Compulsory health insurance may cover the cost of the operation. This is convenient for those who are going to be treated in a city hospital and for whom the budget is of great importance.When treating for CHI, the list of possible operations is very limited. Based on the analysis and examination of the patient, the doctor selects the operation that is necessary. This is often one of the traditional techniques requiring a scrotal incision. In most cases, this operation is available in the medical institution where the attending physician is located. If it is not available there, then the man can be redirected to another clinic. In any case, the payment for the operation is made under insurance.
Testicular hydrocele operation: video
Access to information in recent years has become the broadest and easiest, so that even the most highly specialized topics can be covered for those who are interested in them. The field of medicine is also included in all of this and it will be interesting for many patients to learn more about treatment and operations, which is why various content on this topic is created. Even for the treatment of hydrocele, video operations can be found in the public domain. The more people who are interested in such issues, the more information appears on this topic.
Dropsy of the testicle: video operations for training
One of the directions for which video with operations is being made is the training of specialists who are preparing to become surgeons. This is a long and very responsible process in which all the additional materials prove to be useful, especially as graphic as the video of what you have to do. This illustrates the process in much more detail than any photographs, descriptions, and more.
As a rule, such things create interest mainly for those who need it from a professional point of view. After all, they contain a complete process that lasts 30-40 minutes with certain comments that are of little interest to a wide range of users. But the main thing is that the process of conducting the operation itself is impartial and it is definitely not worth watching for the faint of heart. Despite the simplicity of surgical intervention with hydrocele and a low level of danger, any actions with internal organs are not the most pleasant sight for people.
The operation of the hydrocele of the testicle in the video as a training is created to make them less interesting to patients than to the doctors themselves. Conventionally, such videos can be divided into:
- Video with standard operations, which, although common, but to understand the process, surgeons should look at them before proceeding,
- Innovative techniques that improve the technique of traditional operations,
- The use of new tools in the operation to remove dropsy of the testicle (now there are various laser knives, ultrasound devices and other innovations that were not previously available),
- Fundamentally new methods, which are often found only in private clinics, with which few doctors meet for their practice.
Testicular hydrocele: patient video
In addition to purely professional video materials, you can find those that are designed for patients interested in this topic. Recently, there have been significantly more. They transmit information to users in a simpler and more accessible form. Naturally, some of the data is lost here, but among those who look at such things, few are going to perform these operations. Removing dropsy of the testicle in a video of this nature is more of a sedative effect for those people who have to go through the operation. When a person learns more about what lies ahead, then it becomes easier for him to go for the procedure than when little is known about all this.
Most videos of this nature are created using the forces of any clinics that conduct treatment. The hydrocele operation on the video is shown partially and only the simplest moments without going deeper into the process.Along the way, we talk about the benefits of the operation, the main points through which the patient will have to go and other useful additional information is reported. This serves as a kind of advertising. As a storyteller, a well-known surgeon of this institution often acts and so on.
Rollers of this nature are often of the same type and rarely touch on important details. They communicate only the most important for future customers. You can find them both on the sites of the clinics themselves, and on common video platforms to which everyone has access. They can briefly talk about each type of surgery, so that patients can find out everything they need from their one source, without visiting competitors' resources.
Dropsy testicle operation and video
A special category is represented by video testicle dropsy surgery that advertise new techniques. They do not always have the cost of conducting an operation consistent with quality, safety and effectiveness. Often they give, approximately, the same result as more advanced traditional operations, but at a lower cost. There is hope that in the future they will become more accessible and then their relevance to a wide range of patients will increase. Dropsy of the testicle in men: video is used for accessibility and ownership of information in the field of services.
But while the situation remains the same, treatment services have to be promoted with the help of a video operation of dropsy of the testicle in men, in which all its features will be indicated.
Dropsy of the testicle in men: video of procedures before surgery
In addition to commercials biting the operation, which from a commercial point of view has a completely reasonable approach and great demand, there are also similar things with diagnostics. Determining the correct diagnosis is as important as prescribing the appropriate treatment. A video with examples of the hydrocele itself and how it is determined by a particular technique is also important for doctors and patients.
This is all very relevant for the very majority of people who, before going to the doctor, are looking for all the necessary information on the Internet. Due to the fact that there are a lot of such people and there is a lot of need for this kind of information, various articles, photographs and videos on this topic are created in sufficient quantities at many sources. It really helps to increase the medical literacy of people, but some continue their path of knowledge and go on self-medication, which is definitely not worth doing.
Video: Testicular hydrocele operation
Dropsy of the testicle: Ross operation, video
Naturally, video of testicular dropsy surgery on Ross will be less interesting to a wide circle of users than general information about hydrocele, but in the age of accessible information, even highly specialized topics are surrounded by a lot of detailed thematic content. In the future we should expect an even greater increase in its quantity and quality.
Operation hydrocele: forum
Communication on the forum is a very common thing for active Internet users. Even the subject of medicine and treatment is present in a very active way. After all, anonymity on the Internet allows you to discuss almost all topics and diseases without any embarrassment, which many try to avoid in real communication. Thanks to this, these sites become a good source of information and real experience of people.
On the forum about the operation of hydrocele, you can find a lot of examples of how someone went through a particular operation, what were the consequences and how things are at the moment. Given that over time people go through the same thing, such sites help to find answers to questions that concern many patients without creating new topics.
Naturally, medicine is developing and new techniques are appearing, old ones are improving, and clinics that did not exist before are opening.If we are talking about a hydrocele operation on the forum of a particular city, then the indication of the clinic and the attending physician can greatly simplify the collection of information for patients. People can learn about the qualifications of a specialist for the success of their treatment procedures.
Dropsy of the testicle in men: operation, reviews
Now, almost before every purchase of a product, people study customer reviews about it. In the service sector, a similar trend is also practiced, and every year it is the opinion of people about all this left on the site that affects sales success. When it comes to human health and upcoming treatment, many patients also try to study all possible information via the Internet, especially if it has specifics about the city where the person is located, the clinic in which he is being treated or the attending physician. Testimonials about testicular dropsy surgery in men can help make the right decision if the patient has a difficult choice.
Dropsy of the testicle: reviews after surgery than can help
When studying the comments of other patients, users have a specific goal. Each of them has its own, but on the whole several directions can be distinguished, which can help reviews left by other people:
- Which operation to choose. There are many techniques that are offered to the patient. They have different cost, treatment effectiveness, safety and other features of the conduct. Having studied how much they will have to recover from them, how often relapses occur and whether there may be complications, the patient will make the choice based on the information received, most suitable for him.
- Testicular dropsy surgery: reviews can show which clinic is best to go to and where are more experienced specialists. Indeed, the success of the operation largely depends on the experience of the doctor and if you choose a good specialist, you can avoid many problems in the future.
- Rates and additional surcharges. It often happens that the site shows some prices, but in fact they are obtained by others. In the comments, people indicate why they had to pay extra, whether it was anesthesia, not included in the total cost, hospital stay, tests before the operation and other similar things. All this depends on each clinic individually and it is difficult to find out such information other than other people.
In any case, reviews become an additional source of information that will help to find useful data or just serve to calm when a person, after reading the comments, learns more about all this. In the case of hydrocele, this is indeed so, because most operations are successful and complications with relapses are extremely rare.
Dropsy of the testicle in a child: operation, reviews and whether to trust them
Considering many reviews, sometimes a logical question arises for users: is it worth trusting all those comments that can be found on the vastness of the world wide web. Reviews about the operation of dropsy of the testicle in a child at any sites devoted to medical topics in general may well be credible, as are comments about doctors and clinics located on specially created sites for this. If they are located on the website of a private clinic, then they may well turn out to be fake and do not cause trust.
Surgical treatment of hydrocele
Surgical treatment of hydrocele
Winkelmann testicular plastic surgery is one of the most effective methods for treating small hydrocele. Surgical intervention in most cases allows you to fully restore the function of the testicles.
Before the procedure, it is necessary to pass a set of analyzes for a more accurate assessment of the condition. As anesthesia, local or general infiltration anesthesia is used in combination with conduction.
Plastic surgery includes several stages:
- incision from 3 to 5 cm of the outer anterior surface of the scrotum,
- layered tissue dissection,
- excretion of the testicle along with the vaginal membrane and pumping out the liquid,
- eversion of the membranes after a thorough visual and palpation examination,
- stitching tissue without squeezing the spermatic cord,
- applying a pressure bandage to the scrotum.
After the operation, the treatment of the wound surface and dressing for several days are indicated. On the second or third day, the doctor will remove the drainage. The seam after the operation remains almost invisible.
Bergman’s operation is indicated in the treatment of large hydrocele or in cases where dropsy is complicated by thickening of the testicles. In this case, the neoplasm can be localized both on the left and on the right. The main clinical symptom is an enlargement of one part of the scrotum. When examining the testicle from the side where the dropsy may not palpate, and the other part of the scrotum is without pathological changes.
According to the methodology, the procedure is almost the same as the Winkelmann method. The difference is that in this case, the shell of the organ is excised, and not turned out. During the operation of Bergman, part of the inner leaf is removed, and the rest is sutured.
Lord's operation is prescribed for small or medium sized hydrocele. Small dropsy does not exceed the testicle in volume. The average - is about two to four sizes of the organ.
Before Lord’s operation, hydrocele is anesthetized. Injections - in the thickness of the spermatic cord, subcutaneously at the site of dissection of the tissues, as well as at the root of the scrotum along the anterior, posterior and lateral surfaces of the scrotum from the half where dropsy is localized.
The intervention is less traumatic than others, the rehabilitation period passes quickly, the patient recovers easily. The risk of complications after surgery is minimized, as the surgeon cuts the sac into the vagina, corrugates the vaginal membrane around the testicle, but does not release it from the surrounding tissue, does not dislodge the organ into the wound. With this in mind, it is clear that adjacent tissues are practically not injured, like the vessels, as well as the testicle itself.
Operation and postoperative period
You can get rid of the pathology only surgically
It is impossible to cure testicular dropsy without surgery. To remove dropsy of the testicle, surgical intervention is used according to the method of Lord, Bergman or Winkelman. The choice of testicular dropsy removal method depends on the amount of accumulated fluid.
Intervention is performed under local anesthesia. Do epidural or spinal anesthesia, so the man remains conscious during the operation, but does not feel pain.
The doctor makes an incision on the scrotum, removes the testicle, punctures the membrane and removes excess fluid. Then, the stretched tissue of the membrane is sutured to prevent re-accumulation of fluid, the organ returns to a physiologically correct position and the scrotum is sutured.
The whole procedure takes no more than half an hour, taking into account the waiting time for the action of anesthesia.
The operation for dropsy of the testicle in a child is carried out similarly.
The postoperative period with dropsy of the testicle takes about two weeks. In the first 8-10 days, regular dressings are necessary, so a man should visit the manipulation room every two days.
Sutures are removed approximately 7-8 days after surgery. In the first three days, pain in the testicles can be felt, often the body temperature rises.
To eliminate the symptoms, the doctor will prescribe a number of drugs.
Dropsy of the testicle after surgery does not return, so this is the only effective method to solve the problem.
Removing dropsy of a testicle in Moscow costs from 25 thousand rubles, depending on the chosen clinic. In regions, the cost of an operation starts from 15 thousand rubles.
Forecasts and Prevention
Having understood what dropsy of the testicles in men is, what causes it, as well as its symptoms and treatment, you should know how to prevent the development of the disease.
To do this, you must:
- treat infectious diseases on time
- Avoid scrotal injury
- protect the scrotum during sports.
If a man is injured, you should immediately apply a cold compress to the scrotum and make an appointment with the doctor.
The prognosis for dropsy is favorable. Timely surgery allows you to completely get rid of the pathology and return to a full life in two weeks. Infertility develops only with prolonged absence of treatment for giant dropsy.
Dropsy of the ovary in a newborn boy
The main signs of dropsy of the testicle in the baby are determined visually. Hydrocele manifests itself:
- Pear-shaped enlargement of one or both testicles, with the possible spread of swelling in the inguinal region (swelling is an hourglass)
- The affected part of the scrotum has an elastic consistency, its surface feels smooth to the touch, the skin is not soldered with deep layers and easily folds,
- On palpation, there is no soreness, non-intense fluctuation is fixed,
- Testicular displacement down - is determined only with a slight dropsy, most often the location of the testicle is not determined.
It is worth remembering: in both young boys and men, the left testicle is normally located slightly below the right!
A characteristic feature of hydrocele in infants is the size of the scrotum increases in the evening, the size of the affected testicle decreases after a baby's prolonged sleep. Dropsy of the testicles during the neonatal period does not in any way affect urination.
Ovarian dropsy treatment
The therapeutic tactics of hydrocele depends on the cause and form of the disease. So, a congenital edema found in a newborn at a routine examination does not require treatment; regular monitoring by a pediatric urologist is sufficient.
Only with a large amount of accumulated fluid and the resulting tension of the testicle shells is it punctured. Often, for the treatment of severe congenital dropsy, one procedure is enough to remove fluid from the shell of the testicle.
Repeated interventions are extremely rare.
With post-traumatic dropsy, a violation of testicular integrity should be excluded in the first place. Unburdened hydrocele caused by trauma or inflammation, requires observation by an andrologist-urologist for 3 months.
The lack of improvement, the increase in painful symptoms necessitate surgical treatment of dropsy in men. In the punctured inter-shell cavity, from which the liquid is pumped out, special substances are added sclerosants that prevent the re-formation of dropsy.
- Practical sclerosis of the hydrocystic cavity eliminates the possibility of relapse of the disease. The procedure must be performed by an experienced doctor to prevent hemorrhage and infection.
With organic urogenital pathology that caused dropsy of the testicle, the main treatment includes eliminating the cause of the disease. If necessary, conduct a course of antibiotic therapy.
Types of operations for ovarian dropsy
- The Ross operation is advisable for congenital dropsy of the testicle caused by a non-closure of the message (abdominal process) between the celiac cavity and the intershell space of the testicle. The abdominal process is excised, and then the inguinal ring is ligated.
- Bergman's operation - shown with isolated hydrocele, the inner shell of the testicle is completely excised with subsequent stitching of tissues.
- Winkelmann operation - is to dissect along the front surface of one shell leaf, turn it inside out and stitch it behind the testicle.
- Lord's operation is the least traumatic intervention in terms of preserving the tissues surrounding the testicle and the vessels supplying it.Removal of hydropodic fluid is accompanied by the formation of corrugation of the vaginal membrane, which produces lubricating fluid for the testicle. This type of surgery is not suitable for chronic dropsy with thickened membranes and large hydrocele.
The type of surgical technique is determined by the doctor already during the surgical intervention.
Surgery for dropsy of the testicle in men is often performed under local anesthesia, does not require prolonged hospitalization (on average 1 day of the hospital) and powerful pain relief in the postoperative period.
In the next 5 days, the patient is advised to remain calm, wear a suspensorium, with problems with bowel movements, laxatives are prescribed.
A prerequisite for rehabilitation - 2 weeks you can not wear tight underwear, squeezing the scrotum.
Hydrocele in newborn boys usually resolves by 1 year and does not cause any complications. Chronic disease in adults and the lack of effective treatment leads to irreversible atrophic changes in the testicles and infertility.
A more serious prognosis for dropsy of the testicle, provoked by the inflammatory process. In such cases, puncture with pumping fluid often does not bring a lasting result and leads to more radical surgical intervention.
The most unfavorable prognosis is associated with dropsy, which developed against the background of varicocele. Even after surgery, recurrence of dropsy of the testicle due to stagnation in the lymphatic vessels is observed.
Dropsy of the testicles: varieties, causes and treatment
Testicular dropsy (another name - hydrocele) is a disease during which excess fluid forms in the testicles, which lingers there. Lymph may accumulate, as well as pus or blood, its volume varies from a couple of milliliters to a liter or more (in especially severe cases). Most often dropsy testicle sick newborns and men aged 20 to 30 years.
Causes and varieties of testicular dropsy
One of the membranes of the testicles, called the vaginal, is responsible for the production of fluid, thanks to which the testicle can freely move through the cavity of the scrotum. If the established balance between the amount of produced and absorbed liquid is violated, the accumulation of its excess begins, which is why the dropsy begins. The disease can be congenital and acquired.
Dropsy of the testicles in newborns
In infants, in most cases, congenital testicular dropsy, its cause is the non-closure of the vaginal process located in the peritoneum. As a result, fluid from the peritoneum begins to accumulate in the testicle membrane. Depending on whether there is a message with the peritoneum, congenital dropsy it happens:
- communicating (in most cases, this form disappears during the first year of life, since the vaginal process closes at this time).
Signs of dropsy of the testicle
TO symptoms of dropsy of the testicles include the following symptoms:
- the appearance of aching dull pain in the region of one testicle or scrotum (chronic acquired dropsy of painas a rule, it doesn’t cause), - an increase in one or both testicles in volume, it is not possible to test the testicles, the scrotum skin is smoothed out, but easily folds, wearing underwear and motor activity cause discomfort (with significant accumulation of fluid), - while clicking on the enlarged testicle, you can observe the symptom of fluctuation (on the side opposite to the place of pressure, protrusion of the testicle shells occurs), - spilled enlargement of the scrotum or acute pain syndrome - occurs as a result of large accumulation of fluid, due to which the thinned shell of the testicle breaks into the tissue of the scrotum,
- the temperature may rise.
A significant amount of fluid accumulated in the scrotum causes inconvenience during urination, causes discomfort when walking and causes difficulties during intercourse. If dropsy is congenital, the volume of effusion decreases after sleep and grows during the day.
Testicular dropsy: treatment
Main dropsy treatment method - surgical, with the exception of only children under the age of one and a half years who are diagnosed congenital dropsy. If after reaching this age, the fusion of the vaginal process of the peritoneum did not occur, it is ligated.
Sometimes they practice elimination of dropsy by means of a puncture, however, in most cases, a relapse of the disease occurs. If hydrocele is a consequence of the presence of other diseases (gonorrhea, inflammatory process, etc.), in this case, the first thing to do is treat the root causes dropsy.
If you notice at home primary signs of testicular dropsyDo not delay a visit to the doctor. Neither diagnosis nor its treatment cause any difficulties.
When contacting our clinic, a qualified andrologist will perform an initial examination of the genitals and prescribe an ultrasound scan, which is the most effective way diagnosis of dropsy - the study allows you to assess the condition of the appendage and testicle, as well as measure the volume of accumulated fluid.
The latest equipment used by our specialists makes it possible to establish an accurate diagnosis and make the right decision regarding the treatment method. Moreover, if dropsy is secondaryUltrasound will help determine the cause of its occurrence (orchitis, epididymitis or swelling of the testicle).
Surgery for hydrocele in men: types, preparation, rehabilitation
Hydrocele (dropsy of the testicle) is a common disease, the incidence of which is at least 10% in newborn boys and 1-3% in adult men. If in children this disease is associated with a congenital violation of the correct development of the vaginal process of the peritoneum, then at an older age it is caused by secondary causes: injuries, infectious diseases, postoperative complications.
In most cases, hydrocele develops imperceptibly, without causing any inconvenience at the initial stage. Liquid accumulates slowly, less often - spasmodically. The first sign is an enlarged testicle, which in advanced cases can reach several tens of centimeters. Gradually, a feeling of discomfort occurs when walking, physical activity and sexual intercourse.
The approach to eliminating dropsy can be different. Treatment of hydrocele without surgery is a wait-and-see tactic, since there are no medications for this pathology.
In newborns, dropsy normally goes away on its own during the first one and a half years of life. If serous fluid continues to accumulate, then this is an indication for surgery. In adults, conservative therapy is performed if the patient has inflammation of the epididymis, testicle, or allergic scrotal edema. Treatment consists in observing bed rest, wearing a bandage to support the scrotum (suspensorium), and taking antihistamines or antibacterial drugs.
Indications for surgical intervention
In adult men, dropsy in some cases can also resolve itself. The following factors are indications for surgery for testicular hydrocele:
- a significant increase in the scrotum, causing pain or discomfort,
- cosmetic defect and patient desire,
- the inability to distinguish dropsy from a hernia in the groin,
- a combination of hydrocele with other diseases - spermatic cord torsion, tumor,
Surgery is the only treatment for dropsy with clinical justification and proven effectiveness. It is carried out in a planned manner, with the exception of cases when the hydrocele is acute.
Is it possible to refuse an operation?
In urology, there are 2 types of testicular dropsy:
- isolated non-communicating when the accumulating liquid cannot move to other cavities,
- communicating - the fluid enters from the testicle into the abdominal cavity and in the opposite direction through the vaginal process of the peritoneum.
If a man has a non-communicating dropsy that does not cause discomfort, then the observation can last a long time without the appointment of an operation to remove hydrocele.
However, the accumulation of large liquid can lead to the following complications:
- difficulty urinating
- discomfort during intercourse,
- suppuration of the testicle shells in combination with its inflammation (or appendage),
- hemorrhage in the cavity where fluid accumulates, with trauma or hemorrhagic diathesis.
Types of Surgery
The traditional types of dropsy surgery are carried out according to 4 methods:
- according to Winkelman
- according to Bergman,
- according to the Lord
- according to Ross.
There are also other, minimally invasive methods:
- sclerosing therapy.
In the acute course of hydrocele, an emergency surgical operation is performed, consisting in a puncture (puncture) of the contents and removal of the liquid. After that, apply a pressure bandage. Puncture can be performed repeatedly, on an outpatient basis. However, if a 3-fold procedure does not lead to the expected effect, and dropsy continues to relapse, then in this case, active surgical treatment of testicular hydrocele is preferable. The operation is performed in a hospital (urological department).
How do painkillers do?
Since the area of the scrotum is a very sensitive and most vulnerable place in men, many patients do not decide on surgery due to fear of pain. As a result, the disease reaches a neglected state. The operation to remove excess fluid from the scrotum in children is performed under general anesthesia (intravenously or inhalation). In this case, the child falls asleep for a certain period of time and does not feel anything. During surgery, continuous monitoring of breathing and heart function is performed.
In adults, local anesthesia is most often performed as an injection into the soft tissue of the scrotum. In some cases, do spinal or epidural analgesia. The difference between the two is that in the first case, a single injection is made, and in the second, a thin tube is inserted through which the anesthetic is injected.
Spinal and epidural anesthesia can reduce the sensitivity of the body to zero in the area below the injection. But with local anesthesia, the rehabilitation process is faster. During the operation, the patient feels the manipulations being carried out and may feel mild, tolerable pain. If necessary, an additional volume of anesthetic is administered. In the postoperative period, they continue to inject painkillers or prescribe their oral administration.
The following are the limitations for surgery for hydrocele in the testicle in men:
- inflammatory and infectious processes in the acute stage,
- exacerbation of other chronic pathologies,
- during general anesthesia - diseases of the heart, lungs,
- low blood coagulability.
There are no absolute contraindications for surgery for dropsy, that is, if the above factors are eliminated, surgery is possible. For men at risk, an aspiration (suction) of the fluid is carried out using a needle.Expectant tactics are also indicated for those patients who have only one of the testicles or they are atrophied.
How to prepare for surgery?
Before surgery, standard preoperative preparation is performed. It consists of the following medical examinations:
- UAC and OAM,
- blood chemistry,
- chest x-ray,
- blood tests for hepatitis, HIV and other infections,
- special diagnosis of the scrotum - ultrasound, MRI, diaphanoscopy (translucence to detect formations, cysts),
- if necessary, consultations are conducted with narrow specialists - an endocrinologist, cardiologist, neurologist and other doctors.
The surgical area is prepared as follows:
- on the eve of the operation you need to take a shower
- in a few days you need to stop drinking alcohol,
- the last meal is the night before
- before the procedure - emptying the bladder and shaving hair in the groin.
Duration of the procedure
Many patients are interested in the question of how long the operation lasts for hydrocele. It refers to simple types of surgical intervention. The average duration of a doctor’s manipulation is 20-30 minutes, in the presence of complications it may take a longer time.
After eliminating this pathology, several hours pass until the action of anesthesia ceases. They can be discharged from the hospital on the next day, however, within 24 hours it is necessary to refrain from driving and other high-risk devices due to the reduced reaction rate. General anesthesia in children may require longer rehabilitation in stationary conditions.
Operation Technique for Ross
This technique is used in pediatrics for communicating dropsy. The operation is performed in the following order:
- At the base of the scrotum, a straight or oblique incision is made.
- Bandage the vaginal process.
- A hole is left in the testicles, through which the fluid is absorbed in the surrounding tissues.
- The wound is sutured and a sterile dressing is applied.
The operation technique is almost the same as with an inguinal hernia.
Surgery for hydrocele of the testis according to Bergman is similar to the Winkelman technique. It is indicated in cases where the scrotum is greatly enlarged due to dropsy, as well as in children with a combination of isolated hydrocele and spermatic cord cyst.
The technique is characterized in that a thorough sheathing of the testicle shells is made for their reliable sealing. The fluid is pumped out with a syringe. Access is the same as in the previous case, after manipulation, the testicle is immersed in the scrotum and sutured tightly. Postoperative care - as in the Winkelman technique.
Technique of the Lord
The operation according to the Lord's method is less traumatic. The testicle does not enter the wound, and the vaginal membrane does not turn out, as is done according to Winkelman. Liquid elimination is carried out with subsequent corrugation of tissues in the testicle.
The advantage of this method is to reduce the risk of bleeding. The surrounding tissue is also less damaged.
Minimally invasive surgery
The classical operating procedures described above are associated with the need to perform a rather large incision of tissues to free the testicle and pouch. This can lead to injury to the membranes, damage to blood vessels and bleeding, impaired blood supply and lymph circulation in the postoperative period.
There are the following minimally invasive techniques devoid of these disadvantages:
- Sclerotherapy. The operation consists of a puncture and the introduction of an alcohol or aqueous solution, which contribute to the “bonding” of the testicle shells. As a result, the area in which the liquid can accumulate disappears. This method is an alternative for traditional surgery.He did not find widespread use, since there is a high risk of blood accumulation and the development of suppuration.
- Laparoscopy. It is carried out mainly in children with communicating dropsy. In the area of the umbilical ring, a hollow trocar tube with an optical device is installed to visualize the internal operating area. Working trocars with manipulators are introduced 2-3 cm below the navel. After removing the fluid, the vaginal sac is sutured with self-absorbable sutures.
Operation for hydrocele: reviews
Patient reviews about dropsy surgery are generally positive. After a few hours, motor activity is fully restored. Among the negative postoperative effects, patients note discomfort, a slight pain in the scrotum and a pulling sensation in the suture area.
Within 2-3 days, some patients have a fever that indicates the presence of an inflammatory process. In difficult cases, a hospital stay takes 5-10 days.