Dropsy in boys, in newborns -treatment, complications

Update: December 2018 The emergence of a small crumbs in any family –
This is a storm of the most pleasant impressions and emotions, which, unfortunately,
overshadowed by some alarm tones associated with the condition
health baby

This fear for his breath, sleep, bathing, panic in any sneeze,
sigh or some strange thing. Every visible
discoloration of the skin, form of organs appear young parents
something strange, and young parents begin to examine each
cell body, focusing on the sexual organ.

And if your hero at the touch of the scrotum seems slightly
bluish tint prevails, then most likely
The cause of the problem is a dropsy testicle in a newborn boy.

What is dropsy testicle?

Volumetric scrotal or hydrocele formation is enough
common manifestation in which it is filled with fluid
the sheath of one or both testicles. Testicles of a boy until his
the birth of the light are in his belly inside. Already have
newborn they are found in the scrotum, where gradually
move with time. But often, the egg goes down,
carrying along part of the peritoneum (the film contents of the connective
tissue lining the inside of the abdomen cavity).

That is why dropsy causes an increase in the scrotum
in size and in appearance, it appears slightly swollen in the groin area. AT
principle, this deviation does not cause much discomfort and
considered a painless phenomenon.

If your baby has a swelling in the scrotum and
the predominance of red skin tone, and when touching it, he
starts crying and becomes restless, do not hesitate: urgently
call a doctor at home or consult a specialist in the place
residence. ATодянка, как правило, присутствует чаще у новорожденных
boys In older children, the probability of developing testicular edema is already
lower.

The considered deviation is classified by causal
factors in two ways:

  • Hydrocele is a congenital pathology (it forms up to 3 years),
    which may develop in the fetus in the womb, sometimes
    determined even during pregnancy by results
    ultrasound diagnosis.
  • ATодянка приобретенная, которая может развиться под влиянием
    provoking factors – inflammatory processes, groin injuries,
    testicular torsion, testicular tumors, less often a trigger mechanism
    служить осложнение после ОРATИ, паротита, как послеоперационные
    consequences of hernia repair and other operations.

ATрожденная водянка яичка обнаруживается почти у каждого десятого
a newborn baby, that is, 9% of boys at 1 year of age,
men are only one percent. AT 90% случаев это одноpartiesнее
defeat, often in boys an inguinal hernia accompanies this
pathology. AT педиатрии (детской урологии и хирургии) нередко
There are also such pathologies of the scrotum as accumulation of lymph in
testicular membranes (lymphocele) and dropsy of the spermatic cord
(funiculocele).

The main causes of dropsy of the testicles in newborns and boys
older

Considered deviation occurs in boys for a number of reasons.
different nature. They are basically combined into two large ones.
groups: congenital group and acquired. Causes of development
congenital form:

  • The threat of pregnancy
  • Pathological course of pregnancy (intrauterine
    infection), chronic diseases of women
  • Peritoneal dialysis
  • Premature newborn
  • Birth injury
  • Genetic hereditary factor
  • Increased intra-abdominal pressure

The latter group is more often the result of diseases that
suffered a child:

  • testicular inflammation
  • tumor formation of the testicle and its appendages
  • inflammation of the epididymis (epididymitis)
  • cardiovascular failure and others

Mechanical factors contributing to the appearance
boys disease:

  • abdominal wall defects
  • scrotal injury
  • testicular torsion
  • the result of postoperative complications (hernia,
    varicocelectomy and others)
  • damage to the lymphatic system, etc.

Thus, any mechanical or inflammatory lesion
can damage the anatomical structure of the spermatic cord, namely
lymph nodes, which is accompanied by impaired fluid reabsorption
substances from the vaginal membrane.

It should be noted that there is no connection between
the use of diapers (diapers) and the appearance of dropsy
testicles in the newborn (infant), as well as in the way it
use (should supposedly raise the testicles up, and then
buttoning diapers). The true reasons for the development of such a pathology –
deep internal changes described above, but not external
factors.

Edema classification

Hydrocele can be divided into two types as
connection of the waterbag with the abdominal cavity:

  • Communicating or primary dropsy – when the result
    abnormality is the closure of the vaginal process, at which
    cavity of the vaginal membrane and abdominal with each other
    connected.
  • Isolated dropsy – for this type of vaginal cavity
    testicular and abdominal membranes absolutely not communicating between
    by myself. Thus, the liquid substance accumulates in the shell
    testicles and can not move anywhere.

The first form of a hydrocele is considered more dangerous because
complicated by the development of inguinal hernia. ATедь через полученное
the hole can not only accumulate fluid, but also the hernial
education, which is quite a serious disease,
requiring urgent surgery.

Since in medical practice, dropsy of the testicles occurs in 10%
boys up to a year, without being considered a pathology. Since 8-9
cases out of 10 do not require special intervention by
specialists, and eventually pass on their own as soon as
the inguinal ring will be tightened.

Also, dropsy of the testicle can be seen in two types in
depending on the pressure state of the liquid content inside
water cavity:

  • The stressed form of hydrocele – in which the cavity contains
    liquid substance under strong enough
    pressure.
  • The unstressed form of dropsy of the testicles – the cavity in this case is not
    находится под pressure.

Comparing these two forms, it should be noted that at the maximum
the pressure of the inguinal canal and the abdominal pocket may expand, which
complicate the condition of the child due to the development of a hernia in the groin or
bowel disorders.

Symptoms of hydrocele testicles in newborns and boys under 3
years old

AT подавляющем большинстве случаев водянка яичка не вызывает
особых неприятных ощущений у boys Symptoms of edema of the testicles
newborns are detected first because young
parents constantly carry out hygiene procedures to their babies.
The first visible signs are:

  • some increase in scrotum in size with one or two
    parties
  • groin swelling

Если ребенок может выразить свои ощущения, то с его partiesы чаще
there are complaints of pain, heaviness, or some discomfort at the base
penis. Complicated flow of testicles has
following symptoms:

  • severe pain
  • scrotal redness
  • temperature rise
  • chills
  • nausea and vomiting
  • general malaise, etc.

In practice, there are serious cases of complications of hydrocele
the fault of the patient himself, which is often a teenage boy.
The reason is that because of their age, they are often shy.
talk to parents on this topic, trying to hide arising
health problems. ATследствие чего болезнь приобретает
running stage. So try to talk to your
child about everything, even on such delicate topics.

How to treat dropsy testicle?

In order to save your son from such misfortune as
dropsy of the testicle, should visit the pediatric urologist, who
will appoint diagnostic measures:

  • Transillumination or diaphanoscopy – transmission of the scrotum
    patient light source.
  • Ultrasound – the simplest method, which using ultrasound
    allows you to look into the structure of the scrotum.
  • Laboratory test method (urine and blood test) – method
    exclusion of the presence of concomitant pathologies of the genital organs.

If the boy has a testicular edema, the treatment will be
depend on the age and complaints of the patient. Conservative tactics
implies:

  • In newborns it is a constant observation in
    врача-уролога в возрасте до 2 years old.
  • For older boys, this is an observation for 2.5-3 months, in
    the result of which reveals the nature of the dynamics. If disappointing
    The prognosis is assigned a surgical intervention.

Non-conservative treatment (surgical) implies
назначение операции мальчикам до 2 years old по следующим показаниям:

  • presence of concomitant diagnosis – inguinal hernia
  • intermittent change in scrotum size from magnification to
    decrease
  • the presence of persistent discomfort in the groin area
  • infectious inflammation

If over time the condition worsens, then the only solution
in the treatment of dropsy of the testicles in boys is an operation. Exist
The following types of surgical methods:

Ross’s operation – is used in the reported form of dropsy, when
which the internal inguinal ring is excised and tied.

Bergman operation – used when isolated
hydrocele. The current of this process passes by excision.
the inner shell of the testicle is maximal to the base, sheathed
its residues, in some cases, the installation of drainage and
applying a pressure bandage.

Операция ATинкельмана – данная разновидность метода используется
currently very rare.

Операция Лорда — в отличие от метода Бергмана и ATинкельмана, при
which produces a testicle in a wound, in this case a surgical
the intervention is less traumatic because the vaginal membrane
corrugated in place.

How is the operation – preparation, anesthesia, postoperative
period

  • Before surgery

Before the operation, the child must be completely healthy, after
перенесенного накануне ОРATИ, простуды, любого заболевания
it takes time to recover, at least a month, otherwise
surgery may be complicated by an infectious process or pneumonia.
Before the operation, the control of analyzes is obligatory. blood, urine. how
at least 6 hours before surgery, the boy should neither eat nor
drink.

When dropsy in boys, the operation lasts no more than 20-30
minutes

  • howая анестезия может быть – местная или общая?

General anesthesia is the most humane anyway, even
Considering that with local anesthesia, the doctor controls
situation, general anesthesia is more preferable and safe. She is
helps to avoid psycho-emotional stress in a child by the sight
surgical instruments, specific odors, sounds.
The drugs administered to the boy will quickly relieve the kid’s stress and
вызовут расслабление ребенка, отсутствие сознания на period
operation, unpleasant memories the child will not.

Usually, an anesthetic gas mask is used first.
and when the child falls asleep, an intravenous catheter will be installed. ATся
the operation takes place under the control of blood pressure and
heartbeat. AT конце операции газ отключается и уже через
a few minutes the boy will regain consciousness.

  • After surgery – in the clinic

Already after a few hours the child will be able to drink, and closer to
eat in the evening. Usually on the same day you can leave the clinic or
The next morning. At first, the child will not feel pain, but with
minor pain in the future can be used
НПATС, такие как Ибупрофен или Парацетамол. And in a few days
the wound will not bother the child at all.

  • After surgery – at home

A few weeks worth reducing physical activity.
ребенка, особенно если ему нет 5 years old. Should be avoided
touching the wound in order to avoid bleeding and infection,
therefore it is necessary to explain this to the child. Today suturing
for any operations are made with absorbable materials, if
No, a week later you should visit a surgeon to remove the stitches. AT
2-3 days after surgery around the wound may be
redness, it is not scary, but if it lasts for more than 3 days – this
occasion to visit a surgeon and may indicate a wound infection.
A child may wash, but avoid getting the wound wet.
for a week.

Complications

Even after surgery may develop
complications, they are quite rare:

  • Complications анестезии – бывают крайне редко
  • Infectious complications are also quite rare, but
    it is easily stopped by taking antibiotics for 7-14 days
  • Bleeding is also a rarity eliminated by the creation in the area.
    pressure wounds, as a last resort by surgical intervention
  • ATозникновение рецидива водянки яичек – если яички после
    operations are higher than before it, be sure to ask for
    consultation to your attending urologist.
  • ATозрастание риска бесплодия – если во время операции
    the seminal ducts or vessels supplying the testicle are damaged, this is
    may affect reproductive function in the future, especially
    in the presence of any pathology and in the second testicle
  • Fastening the testicle with scars with a strong lift up
  • The development of testicular atrophy as a cause of system impairment
    blood circulation
  • The appearance of pain and discomfort in the area
    groin

ATо избежание перечисленных выше последствий следует строго
comply with all recommendations of the pediatric urologist, regularly handle
sexual organ, maintain hygiene, keep calm and avoid
physical exertion.

ATо все времена многие специалисты урологии считают, что
prerequisites for the development of problems with men’s health and
репродуктивной системой закладываются в первые 5 years old жизни ребенка,
which can be associated not only with congenital abnormalities, but
and with non-compliance with the rules of personal hygiene. Therefore very important
to teach his son to properly monitor the cleanliness of the genitals.

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