Patient's question:
Hello, doctor, my son is now 1 year and 10 days old. A few months ago, we noticed that sometimes the size of his testicles is not the same, sometimes it's quite noticeable, and sometimes it's not. His left testicle is larger than the right one. We had a check-up at the county hospital, and the doctor said it's not a hernia, but rather hydrocele of the tunica vaginalis, which was caused by remnants of the fetal cord that didn't fully absorb after birth. Currently, it doesn't need to be treated, and if it hasn't been absorbed by itself by the time he's 3 years old, surgery will be required. For now, no special treatment or care is needed.Yesterday, we had another ultrasound check-up at the city children's hospital, and the result was "40×21mm of fluid accumulation in the left testicle."
Doctor's answer:
Here is the English translation of the provided text, with line breaks preserved as instructed:---
I. When newborn infants have hydrocele of the tunica vaginalis, it often disappears on its own before the age of two, so treatment is not urgent. If it persists after two years, a significant number can still resolve by the age of four or five. If it hasn’t improved by age six, aspiration may be performed. In most cases, recurrence does not occur after aspiration. This method is not suitable for adults. In adults, the fluid often reaccumulates shortly after aspiration.
II. Injection Therapy
After aspiration, irritating substances such as silicone or sodium selenite are injected into the tunica vaginalis to induce inflammatory adhesion, aiming to obliterate the cavity. This method causes significant reactions, incomplete adhesion, and may lead to multilocular hydrocele, making surgical treatment more difficult. It is rarely used.
III. Surgical Therapy
Since congenital hydrocele cannot be treated with the above methods, surgical treatment is the primary approach. The goal is to ligate the inguinal canal at a high position to block the downward flow of peritoneal fluid. The following hydrocele sac can be left untreated.
IV. Traditional Chinese Medicine Therapy
Traditional Chinese medicine experts believe that based on the symptoms, this condition is attributed to deficiency, cold, and dampness stagnating in the lower burner. It is recommended to use herbs that tonify qi, reinforce the exterior, warm and resolve cold and dampness, supplemented with qi-regulating herbs. Hydrocele is a condition of fluid accumulation and edema in the scrotum. Symptoms include swelling and pain in the scrotum, intermittent discharge of clear fluid, or a swollen, shiny scrotum resembling crystal without redness or heat. It may also cause itching, ulceration with yellow discharge, or a gurgling sound when pressing the lower abdomen.
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