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Hydrocele (अंडकोश में पानी) Definition, Cause, Symptoms, Diagnosis, Treatment |Dr. Shipra Mishra|
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- เผยแพร่เมื่อ 29 ก.ย. 2023
- Hernia hydrocele me antar, hydrocele kya hai?, hydrocele ko kaise phchane, हर्निया हाइड्रोसील में अंतर, हाइड्रोसील को कैसे पहचाने?, हाइड्रोसील क्या है?
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HYDROCELE
Collection of excessive fluid in the tunica vaginalis sac (TV sac).
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Types-
• Congenital
• Acquired - Primary
- Secondary
Etiology-
• Defective absorption of fluid by the tunica vaginalis, probably due
to damage to the endothelial wall by low-grade infection.
• Excessive production of fluid as in secondary hydrocele.
• Interference with drainage of fluid by lymphatic vessels of the
cord.
• Communication with the peritoneal cavity.
I. CONGENITAL HYDROCELE-Occurs due to patent processus vaginalis sac either completely or partially.
Types
1. Vaginal hydrocele- Occurs when hydrocele sac is patent only in the scrotum.
2. Infantile hydrocele-The sac from the scrotum is patent up to the deep inguinal ring.
3. True congenital hydrocele-In this condition, the scrotal sac communicates with the peritoneal cavity. It is seen in infants, may be secondary to TB peritonitis. The scrotal swelling appears when the child assumes an erect posture for a long time and it may not reduce due to
inverted ink bottle effect.
4. Encysted hydrocoele of the cord-In this condition the sac is obliterated above (inguinal canal) and below (scrotum) but patent at the root of the scrotum around spermatic cord.
5. Hydrocoele-en-Bissac (bilocular hydrocele)-
In this condition, the scrotal sac communicates with another sac underneath the anterior abdominal wall musculature.
6. Hydrocele of canal of Nuck-It presents as a swelling in the inguinal region in female.
II. ACQUIRED HYDROCOELE
a. Primary or idiopathic
b. Secondary hydrocele.
1. Primary vaginal hydrocele
• This is the most common type of hydrocele which is seen in young adults, middle age and beyond.
• Soft, cystic, fluctuant swelling
• Not reducible, No impulse on cough
• Testis is not palpable as it usually attains a large size (unlike secondary hydroceles which are small, except in filarial hydrocele).
• Initially transilluminant but long-standing hydrocele is nontransilluminant (due to thickened dartos, thickened spermatic fascia, thickened hydrocele sac, infected content, chylous fluid, often filarial hydrocele, haematocele).
Secondary Hydrocele Cause
1. Recurrent epididymo-orchitis due to filariasis
2. Tuberculous epididymo-orchitis- Retrograde infection from the seminal vesicles.
3. Testicular tumours: They can present with a swelling of the scrotum, often diagnosed as hydrocele.
4. Pyocoele: Infected hydrocele.
5. Chylocoeles- The fluid is milky white.
6. Haematocele: Trauma to the hydrocele or spontaneous bleeding into the sac.
Treatment of hydrocele-
• Subtotal Excision
• Partial Excision And Eversion (Jaboulay’s Operation)
• Evacuation and Eversion
• Lord’s Plication
Procedure-
• Under GA or spinal or LA, after cleaning and draping
• Vertical incision of about 6-8 cm in length is made over the scrotum,
anteriorly 1 cm lateral to the median raphe.
• Skin, dartos, external spermatic fascia, internal spermatic fascia are incised.
• Bluish hydrocele sac is identified. Sac is opened.
• Aspiration is a temporary method and there is a chance of introducing
infection. It can be done only in high-risk patients.
• Lord's plication- If Medium sized, thin walled hydrocele which contains
clear fluid
• Evacuation and Eversion- Fluid is evacuated using trocar and cannula. Sac is Everse.
• Partial excision and eversion of the sac(Jaboulay's operation). This is
indicated in large hydrocoeles. The thick, large, sac is excised and is sutured
behind testis.
• Subtotal excision of the sac- If the sac is thick, in large hydrocele and
chylocele.
Very neat and clear explanation....thank u mam❤️
Nice mame
Very informative video.
Very nice information
Very informative
mam i passed my finals just because of you , thanks a lot ❤
Wlcm beta… god bless you…
Good
Mam can I ask one question
Ask?
Ye videos fmge k liye bhi h kya mam ?
Fmge?
Mam agar hydrocele ka Opration karne ke baad eversion karne se testies ko koi nuksan nhi hoga ? Kyuki testies toh phir bahar aa jayega sroctam mei
Nhi hota h nuksan
Mam Keep continue yours lectures. Aap lamba gap mar deti h
Ap ka instagram nai open horaha i have a questio