Hydrocele



Collection of fluid between the parietal and visceral layers of tunica vaginalis

Can be various types depending on what part of the processes vaginalis obliterates

- complete = 'congenital'

- distal failure to obliterate = 'vaginal

- middle mailure = encysted

- proximal failure = funicular

Congenital: Failure of tunica vaginalis to obliterate in all or part of its length
- may be confied to scrotum; most close within 6m
- may be in cord
- may be completely patent processes.

Acquired: Primary of secondary

    Primary – usually in older men. Due to defective absorption of fluid.

    Secondary:

o   Trauma

o   Tumour

o   Torsion

o   epididymo-orchitis.

o   Usually occur in men age 20-40. US to examine underlying cause.


 

Examination: Balloon-like swelling
Does not usually cause symptoms; painless swelling
Cannot feel testis separately, trans-illuminates, Can get above it.

Indications for surgery are enlargement, discomfort, and patient preference.
- needle aspiration usually --> recurrence.
Discourage surgery in pts wishing to have children
- risk of damage to blood supply

Operative: Open hydrocoele sac


 

1. Jaboulay procedure

 


 

 

2. Lord’s placation