Patient's question:
My son is 20 days old, and the hydrocele has not improved. Is this serious? What measures should be taken? Thank you!Doctor's answer:
Hello, under normal circumstances, there is a small amount of fluid in the tunica vaginalis of the testis, which serves to lubricate the testis. If the fluid increases, it becomes hydrocele.1. Based on the location of the effusion and whether it communicates with the peritoneal cavity, it is classified into 4 types:
① Communicating hydrocele.
② Inguinal hydrocele.
③ Inguinal and testicular hydrocele.
④ Testicular hydrocele.
2. When the effusion is large, it may cause a sense of fullness or swelling, and a localized mass can be palpated.
3. On examination, the effusion in the scrotum can be felt as a cystic mass. The transillumination test is positive.
4. To differentiate from inguinal: The hernia sac has a larger pedicle, the contents are often reducible, and the inguinal orifice is enlarged. There is a sense of during coughing, and the transillumination test is negative.
5. To differentiate from testicular: The tumor mass is harder, the entire testicular volume is enlarged, and a heavy sensation is felt when the mass is lifted with the hand. The transillumination test is negative.
Treatment Principles
1. Hydroceles in infants under 2 years of age often resolve spontaneously and do not require surgical treatment. Puncture and aspiration are not effective, as the effusion often recurs quickly after being drained. This method is generally not used.
2. Larger hydroceles or those with significant symptoms should undergo partial tunica vaginalis excision and inversion. For communicating hydroceles, high ligation of the processus vaginalis is performed at the internal inguinal ring.
The surgical prognosis is generally good.