Edema of the testicle in men: symptoms, treatment,operation

Update: October 2018

Water drops in men occurs when fluid accumulates in the thin
saccular formation in the scrotum around the testicle. Disease
manifests painless increase in the size of the scrotum on the patient
side due to violations of the outflow of the produced fluid.

Dropsy, or hydrocele, often develops on one side
scrotal, but not excluded, and bilateral accumulation of fluid.
Congenital dropsy occurs in approximately 10% of boys and
1% of men over the age of 40 years. Moreover, most of them
the disease passes on its own within 1 year. Second peak
The incidence in men is over 40 years old. In this
case of disease caused by inflammatory diseases
and scrotal injuries.

In the absence of timely treatment, hydrocele can
to progress over the years, taking huge sizes (10 cm in diameter
and more).

According to the statistics on the incidence of hydrocele in
In the UK, 99% of patients with hydrocele were hospitalized in
specialized hospitals, and 9% of them were required
urgent Care. The average time of hospital stay of a patient with
dropsy was 1.9 days. 43% of patients are men from 15
up to 59 years. The average age of patients hospitalized with
The diagnosis of “dropsy testicle” was 39 years.

Causes of hydrocele testicles

Although the mechanism of the disease is not fully understood, it has been proven
that the accumulation of fluid in the scrotum arises due to the violation of its
outflow. There are the following possible causes of dropsy in the testicle.
men: Водянка яичка у мужчин

  • Infectious diseases
  • Testicle injury
  • Tumor
  • Swelling of adjacent organs and lower limbs

All of these conditions are accompanied by complete or partial blockage.
excretory ducts responsible for maintaining a normal amount
fluid in the scrotum, and lead to its excessive accumulation and
stagnation Risk factors for the development of dropsy should also
include:

  • Surgical procedures on the perineal organs and exposure
    ionizing radiation (radiation therapy).
  • There are data linking ascites (accumulation of fluid in the abdominal
    cavity) with edema. This is possible with congenital or acquired
    abnormalities of the duct connecting the abdominal cavity with the scrotum. In this
    case in the course of surgical treatment of dropsy correction is carried out
    this duct.

Symptoms

Symptoms водянки яичка у мужчин имеют невыраженный характер и в
most cases are missing. Accumulation of fluid inside
testicular membranes are painless and lead to gradual
increase the size of the scrotum. In some cases, the amount of accumulating
liquids may increase spasmodically (with acute
inflammatory diseases or in the early postoperative
period).

An increase in the scrotum with dropsy can reach 10 or more
centimeters in diameter, which results in:

  • difficulty in walking, urinating,
    feeling heavy
  • such patients note discomfort when having sex
  • the scrotum becomes dense with a palpable feel
    fluid inside the membranes, painful palpation is not
    causes
  • characteristic feature of the hydrocele is the impossibility
    determine the contours of the testicle due to increased fluid accumulation.

In severe infectious diseases exudate may
subjected to suppuration, which leads to the development of piocele. it
the condition is considered a complication of dropsy and is manifested by a sharp
deterioration of the patient’s condition, fever and
the spread of inflammation in the surrounding tissue. In this case, often
there are painful sensations in the area of ​​inflammatory
hearth.

Besides piocele, the lack of timely treatment can cause
The effects of hydrocele testicles such as:

  • Crush testis blood vessels. This condition leads to
    testicular atrophy and reproductive impairment
  • Bleeding due to vascular injury with the development of hematocele
    (accumulation of blood between the membranes of the testicle)
  • Sheath rupture due to overstretching due to excessive accumulation
    liquids
  • The development of scrotal hernia

Diagnostics

With the development of a condition such as dropsy of the testicle in men,
treatment is aimed at eliminating the causes and effective
prevention of complications of the disease. Any therapeutic manipulations
made by a doctor only after the necessary
survey. In the course of diagnosis, the doctor will definitely evaluate a number of
tests to rule out comorbidities and conduct
differential diagnosis with scrotal hernia.

  • Diaphanoscopy

One of the rapid methods of confirming a diagnosis is
diaphanoscopy. The essence of this method is to transmit bright
light through the enlarged portion of the scrotum. Since the liquid is at
hydrocele does not contain any impurities or foreign bodies, then
the light passes through the tissue freely, thus confirming
diagnosis.

  • Ultrasound

However, the main diagnostic criterion, based on
whose final diagnosis is set is
ultrasound to allow accurate assessment
анатомических структур мошонки и определить объем liquids внутри
testicular membranes.

Upon detection dense formations or uncharacteristic for
hydrocele impurities may need additional study.
on cancer or inguinal inflammation
organs.

Treatment of dropsy of the testes in men

Для лечения не обязательно требуется operation: водянка яичка у
men can pass on their own in the absence of provocative
factor a. To this end, it is necessary to accurately determine the cause of the development.
diseases and eliminate its further impact.

If dropsy is caused by epididymitis or another.
inflammatory disease then the treatment is aimed at eliminating
inflammatory manifestations and infection control. So sick
prescribed a course of antibacterial drugs and nonsteroidal
anti-inflammatory drugs.

In case of injuries of the testicle, accompanied by swelling of surrounding tissues,
therapeutic measures are aimed at normalizing blood and
лимфообращения для улучшения оттока liquids. Often hydrocele
passes independently without additional interventions. With
the inefficiency of the manipulation or increase the severity
symptoms of the disease, patients are treated with surgical treatment.
dropsy testicles. For this purpose, apply:

  • Hydrocelectomy

There are several operational techniques, among which the most
methods proposed by Winkelman and Bergman are common. it
simple regional surgeries
anesthesia. During the operation, the surgeon makes an incision in the scrotum or
the lower abdomen, after which the condition of the channel connecting
the abdominal cavity with the scrotum, and the hydrocele is removed. During
operations may need to install a drain tube for
prevention of postoperative recurrence of dropsy. This tube
cleaned in a few days. Cold is also applied topically to
reduce swelling.

  • Пункционная аспирация liquids

Эта манипуляция предполагает выведение скопившейся liquids
through the needle inserted into the scrotum. itт метод не получил широкого
spread as it has a temporary effect and does not provide
full recovery of the patient. For efficiency after
аспирации liquids в иглу вводят склерозирующий препарат,
позволяющий уменьшить количество продуцируемой liquids. itт метод
used to treat patients with pronounced
contraindications for surgical treatment.

With неправильной пункции оболочек яичка могут наблюдаться
serious bleeding or infection complications with
the development of inflammatory diseases. With оперативном лечении риск
Damage to the testicular vessels is reduced as the surgeon performs
careful visual inspection and corrects the size of the cut,
based on the state of the tissue in the area of ​​intervention.

Postoperative period

The recovery period does not require a long observation of
condition of the patient. Patients undergoing surgery for
hydrocele, can lead a former life without functional
restrictions almost immediately after treatment.

Immediately after surgery, the patient is transferred to the ward,
where is the assessment of its vital indicators and
control of the postoperative wound condition
bleeding. The statement is made on the day of surgery with recommendations
home surveillance.

The control application is appointed a few weeks after
operations to assess wound healing over time and eliminate its
infection. Puffiness of tissues may persist for
several months after removal of hydrocele. If at the same time
there is a worsening of the patient’s condition, fever
body redness in the area of ​​operation, you must immediately
consult a doctor.

Forecast

Forecast течения водянки у мужчин благоприятный. In most
cases the disease passes on its own. Postoperative
relapses are very rare and occur only in the treatment of large
hydrocele.

The risk of infection during the operation does not exceed 2%. None
however, a possible complication is trauma to the spermatic cord,
accompanied by impaired reproductive function. In most
случаев operation имеет положительный эффект, полностью устраняя
defect of the membranes and preventing the development of relapses.

Return to normal life occurs within 10 days
after surgery, although hard work and sexual activity
banned for a period of 4-6 weeks. Fatal Data
associated with surgical treatment of hydrocele, no.

Автор: Коробов Никита Александрович врач-анестезиолог

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