Hydrocele and spermatocele

Hydrocele or spermatocele must be operated in general ...
Definition
As a hydrocele is a collection of fluid in the testicular capsule (hydrocele) or is designated on the epididymis (spermatocele). The disease in most cases, surgical treatment is required.

Causes
A hydrocele may be congenital, for example, if there is an abnormal connection between the abdominal cavity and the scrotum remains. But there are also acquired water breaks, which can be caused by various factors such as inflammation of the testicles (orchitis) or epididymitis (epididymitis), injuries or tumors. Sometimes no cause can be found.

Symptoms
The scrotum swollen by the liquid. Often there are no other complaints, but it can lead to pain and an unpleasant feeling. A very pronounced testicular swelling can lead to impairments in movement (eg walking). It can be caused by decreased blood flow to an injury to the testicle, which can even lead to infertility. Also there may be a hernia, which can be trapped eg intestine, which can lead to future problems. In infants, the hydrocele is often back again.

Diagnosis
It is the questioning (medical history) of the patient or the parents and the physical examination. The doctor scans the scrotum and illuminates it (transillumination). When coughing, and in the abdominal pressure is increased, the swelling (not unlike the hernia). The water fraction can be well represented in an ultrasound examination.

Differential Diagnosis
Other diseases associated with a thickening of the scrotum must be distinguished. These include hernias, hematomas, and tumors (eg testicular cancer).

Therapy
Conservative therapy
In the first year of life is a treatment not yet meaningful. Thereafter, the fluid accumulation pierced with a needle and aspirated or expired can be. The effusion is however within days to weeks after, so that a re-piercing, or for permanent treatment will require surgery.

Operation
The operation of a water break (hydrocele, spermatocele) is done under regional anesthesia (anesthesia of a larger area of ​​the body) or general anesthesia.

It is made an incision on the scrotum or the groin. The testis is dissected along with its coverings.

With a hydrocele (water break in the testicular capsule), the testicular capsule are incised. An excess tissue is removed, sealed a connection to the abdominal cavity.

With a spermatocele (water break at epididymal) requires excision of the fracture is performed.

After the action, the incisions in the skin with sutures are closed again. Withdrawn fluid and tissue is examined, particularly to exclude a malignant tumor.

Possible extensions of the operation
In case of complications or unexpected findings, it may sometimes be necessary to make an extension or modification of the surgical method. Sometimes, for example, is also from a hernia, for which treatment further action is required.

Complications
The operation of a water break is generally a low-risk surgery. Organs and structures can be injured in the operation area. In vascular injury may lead to bleeding, bleeding and bruising. Nerve injury can lead to numbness or pain, among other things. It is possible that a testicle or vas deferens is damaged. It may also come to the water accumulation in the scrotum (hydrocele). Infections, impaired wound healing, tissue swelling, excessive scarring can occur. Allergic reactions can not be excluded.

Note: This section can only give a brief outline of the most common risks, side effects and complications and is not intended to be exhaustive. The conversation with the doctor can thus not be replaced.

Forecast
Typically, hydrocele and spermatocele be permanently removed by surgery. It is still possible that there is a recurrence (relapse) of the water fraction. In this case, re-treatment measures are necessary.

Notes
Before the operation
Drugs that inhibit blood clotting, such as aspirin or warfarin ® ® must be discontinued usually in consultation with the doctor before surgery.

After the operation
If the operation is performed on an outpatient basis and with pain medication effect, so pay attention to the patient that he must operate for 24 hours, no car, no transportation and no other machines themselves. Therefore, he should be picked up. Significant decisions should also be postponed.

After consultation with the doctor is required for some time, a physical rest. The stitches removal is performed by the doctor after about eight days. For a few weeks' time, such as a scrotal support (jockstrap) are borne on the scrotum or testicles be elevated as a prop.

If abnormalities are observed, which may indicate complications, it should not be hesitated to contact the physician.