testicular hydrocele
Introduction
Introduction to testicular hydrocele Testicular hydrocele is a cystic lesion that accumulates more than normal in the sheath cavity of the testis, and can be seen at various ages. It is a common clinical disease, clinically according to the location of the hydrocele and the sheath. The degree of sudden closure, the hydrocele is divided into four types: positive testicular hydrocele, traffic testicular hydrocele, spermatic testicular hydrocele, mixed testicular hydrocele. The main clinical symptoms of the patient are: cystic mass in the scrotum. There is no extraordinary discomfort when the amount of fluid is small. When the amount is more, the traction index is indexed as dull pain and testicular heat in the erect position. In severe cases, it may affect urination and normal. Daily life, such as giant testicular hydrocele. basic knowledge The proportion of illness: 0.001% Susceptible people: male Mode of infection: non-infectious Complications: syphilis filariasis
Cause
Causes of testicular hydrocele
Disease factors (65%):
Secondary hydrocele has primary diseases, such as acute orchitis, epididymitis, spermatic inflammation, etc., which stimulates the increase of cerebral effusion, resulting in effusion. Scrotal surgery damage lymphatic vessels caused by reflux disorders, as well as high fever, heart failure, ascites, etc., manifested as acute hydrocele; chronic secondary effusion is common in chronic orchitis, epididymitis, syphilis, tuberculosis, testicular tumors, etc. Increased secretion of the sheath and effusion. In addition, filariasis and schistosomiasis can also cause hydrocele. White blood cells are often contained in the liquid.
Body factor (30%):
This may be due to increased secretion of the sheath and decreased absorption, possibly due to undetected or healed testicular epididymitis. It is also associated with congenital factors, such as defects in the sheath lumen lymphatic system, and the progression of the disease is slow.
When the testicles descend from the retroperitoneum to the scrotum, the peritoneum descends and becomes the testicular sheath. The sheath surrounding the testicular and epididymis is a visceral layer of the sheath, and a layer of sheath is present on the outside. There is only a small amount of liquid between the two layers. The sheath that descends with the testicle is completely closed after birth and becomes a cord. If the sheath is not closed at all, the intra-abdominal fluid (ascites) can flow along its unclosed lumen to the testicle or stay on a segment of the spermatic cord, forming a hydrocele called congenital or traffic hydrocele . If there is too much fluid between the two layers of the testis, it is the testicular hydrocele.
The testicular hydrocele is clinically characterized as a cystic mass of the scrotum. Parents will find that the testes on both sides are not the same size. From the perspective of the characteristics of the tumor, the hydrocele can be roughly divided into two categories: traffic and non-transportation: the former When the tumor is large and small, it will become smaller or even disappear when sleeping or hand-pressed, but the tumor will return to its original state after waking up or playing with the pressurized hand; the mass of non-communicating hydrocele The size does not change or gradually increases, it feels hard when palpated by hand, and does not shrink when pressurized.
In the early stage of normal fetal development, the testicles are in the retroperitoneum. From July to September, the testes descend to the scrotum through the inguinal canal, and the peritoneal sheath-like process with the fall of the testicles forms a fibrous cord. The sheath of the testis forms a cystic testicle. Intrinsic sheath. Under normal circumstances, there is only a small amount of liquid that oozes and absorbs balance in the cavity, and when pathological changes such as inflammation, tumor, trauma, parasitic disease, etc. occur in the adjacent organs of the sheath, the effusion and absorption functions are out of balance, or The peritoneal sheath is insufficiency, and the fluid in the peritoneal cavity reciprocates into the sheath lumen, thereby forming a testicular hydrocele.
Prevention
Testicular hydrocele prevention
The incidence of hydrocele in the tropics is high and is related to the infection of blood worms. Therefore, anti-mosquito measures are important. Once you find yourself sick, be sure to go to a regular hospital for treatment. Do not use your medicine indiscriminately. It should be very important to note that because chronic epididymitis often coincides with chronic prostatitis, it should be treated with the same two diseases.
Complication
Testicular hydrocele complications Complications, syphilis filariasis
Under normal conditions, the wall of the sheath has the function of secreting and absorbing the serum and keeping its capacity stable. If the sheath itself and surrounding organs or tissues are diseased, and the secretion and absorption functions of the sheath are unbalanced, various types of hydrocele are formed. The general prognosis of this disease is good after treatment with Lishui Xiaoyu Recipe. The scrotum of the primary testicular hydrocele is normal, with a large tension and can transmit light. Such as the sheath tension is not large, relatively soft, should be thought of as secondary hydrocele, should be alert to testicular, epididymis lesions, such as tuberculosis, syphilis, inflammatory lesions, tumors and filariasis. The hydrocele appears as a cystic mass in the scrotum or spermatic cord. Generally, there is no discomfort, and the size can vary greatly. Most of them are oval. When the congenital hydrocele is in a supine position, the effusion can be gradually reduced or even completely disappeared, and the hydrocele is mostly unilateral.
Symptom
Testicular hydrocele symptoms common symptoms testicular pain epididymal cyst testicular pain testicular tenderness dull pain
There is a cystic mass in the scrotum. When there is a small amount of fluid, there is no extraordinary discomfort. On the contrary, when the amount is more, the traction index is indexed as dull pain and testicular heat. In severe cases, it can affect urination and normal daily life, such as giant testicles. Hydrocele.
Examine
Examination of testicular hydrocele
Testicular hydrocele and spermatic hydrocele are generally spherical or ovoid. Infant hydrocele is pear-shaped and tapers in the groin. Traffic hydrocele is spherical or pear-shaped, which can be reduced or disappeared when lying down. Sometimes the traffic hole is very small, and it can be slightly reduced in bed for a long time, so it is easily misdiagnosed as infantile hydrocephalus or testicular hydrocephalus. The surface of the mass is smooth, elastic and cystic, and the tension is small.
Diagnosis
Diagnosis and differentiation of testicular hydrocele
diagnosis
Diagnosis can be performed based on clinical performance and laboratory tests.
Differential diagnosis
The hydrocele is mainly distinguished from the inguinal hernia and testicular tumors.
The formation and anatomy of the traffic hydrocele and the inguinal hernia are the same. However, the diagnosis is different because of the different contents of the sac. When the patient is standing, if the mass is rapidly protruding along the inguinal canal, sometimes the intestinal type or the bowel is visible, it is sputum. The intestine can be touched during the examination. The outer ring is large. The scrotum of the traffic hydrocele gradually increased, and the inguinal canal showed no obvious mass, and the spermatic cord was not coarse. When doing the light transmission test, it is necessary to pay attention to the baby's intestinal tube is thin, although it is sputum, its light transmission is still positive. To be careful, you should not rush to puncture, so as not to accidentally injure the intestine. To identify whether the spermatic hydrocele should check for the coarseness of the spermatic cord at the upper end of the mass. If it is thick, the mass is connected to the abdominal cavity, which is . If it is not thick, it may be hydrocele. In testicular hydrocele, the mass occupies all of the scrotum on one side. Can't touch the testicles anymore. The testicles can be touched except for the contents.
Testicular tumors are characterized by heavy and hard. There may be a small amount of hydrocele, and the B-ultrasound can be seen as substantial. At the time of examination, in addition to the heavy weight of the mass, if the epididymis is touched outside the mass, it is a tumor. If there is no epididymis, it may be testicular hydrocele. The light transmission test tumor was negative. However, thick-walled hydrocele can also be opaque. Puncture can be performed to confirm the diagnosis.
