Download - hydocelectomy AZIS
HYDROCELE
AZIS AIMADUDDIN AI
Definition
an abnormal collection of fluid in the tunica vaginalis that may surround the testicle
Glenn's Urologic Surgery, 6th Edition. 2004
Campbell Walls Urology.10th Ed.2012
Caused by excessive fluid secretion by the visceral tunica albuginea without adequate reabsorption of this fluid by the parietal peritoneum around the testis
Anatomy
EMBRIOLOGY
Hydrocele
Non communicating hydrocele
Testicular hydrocele
Cord hydrocele
Communicating hydrocele
CLINICAL FEATURES
Testicular hydrocele
•Size didn’t change•Difficulty to palpate testis
Cord hydrocele•Size didn’t change•Mass upper the testis•Palpable testis
Communicating hydrocele
•Size bigger when crying or activity•Hydrocele sac separated from testis
Hystory taking: Painless scrotal swelling
Communicating hydrocele
An open processus vaginalis leads to varying amounts of serous fluid in the cavum vaginalis testis.
Non communicating hydrocele (testicular hydrocele)
Accumulation of serous fluid in the cavity of the tunica vaginalis of the testis, without communication of the hydrocele with the abdominal cavity
Non communicating hydrocele (cord hydrocele)
accumulation of serous fluid in a non-obliterated part of the processus vaginalis without communication with the abdominal cavity or tunica vaginalis of the testis
Testicular Tumors Epididymal cyst Spermatocele Hernia scrotalis
Differential Diagnosis :
Positive transilumination
Indication to surgical treatment
Some indications to perform surgery on hydrocele is: (1) a large hydrocele that can suppress the blood vessels, (2) an indication of cosmetics, and (3) permagna hydrocele which were interfere with the patient in performing daily activities.
Contraindication
Local Infection
Coagulation Disorders
Testicular neoplasm
Glenn's Urologic Surgery, 6th Edition
PROCEDUR Communicating hydrocele( high ligation )
Atlas Pediatric Surgery
Atlas Pediatric Surgery
Non Communicant Hydrocele PROCEDUR
Jabulay technic (testicle hydrocele)
Do marsupialitation and plication of vaginal tunica
Jaboulay procedure
Lord technic (testicle hydrocele)
Excise and plicate margin of vaginal tunica
Technical operation
For cord hydrocele, made blunt preparation to find hydrocele and do intoto extirpation
Post operative care
scrotal support.
analgesics.
Wound toilet
COMPLICATIONS
Early Complication Late complication
Hematoma. Infection.
Scrotal abscess Recurrent hydrocele Spermatocele
(Campbell-Walsh Urology, 10th. Ed. 2011)