birth of a child - always a joy for young parents.But sometimes it may be overshadowed by the disease.Especially if its causes and consequences are not clear at all.Not only are a lot of questions, but a real panic among parents causes swelling of the scrotum and its blueness of the skin of the boy.
hydrocele (hydrocele) - single- or double-sided pathological process in which fluid accumulates in the scrotum.
Sometimes hydrocele accompanied by other diseases: inguinal hernia, lymphocele (accumulation of lymph in the scrotum as a result of pressure or trauma limfososudov) lymphostasis eggs (stagnant lymph) and funikulotsele (dropsy of the spermatic cord). Content
testicles in the fetus are in the abdomen and descend into the scrotum aroundseventh month of development, while drawing with a thin film of the connective tissue, peritoneum, which lines the inside of the cavity in the baby's tummy.This forms a pocket.Normally, it must be closed before the birth or within the first months of life, but sometimes it does not.Next, the mechanism of accumulation of fluid depends on the type of hydrocele, which can be isolated or reported.
When communicating hydrocele peritoneal fluid goes into the pocket of the processus vaginalis, which connects the abdomen and scrotum.In most cases this process to one and a half years may close on their own, but still let the disease take its course does not.
When an isolated hydrocele fluid produced by the tunica vaginalis testis.Normally, it is necessary to ensure that the egg to move freely inside the scrotum.At the same time strike a balance between its generation and absorption.If it is broken, the liquid begins to accumulate, and there is a hydrocele.
Conditionally causes of hydrocele can be divided into two major groups: congenital and acquired.
Congenital hydrocephalus malformation is considered small and is not related to the mutation of genes.For it is characteristic of the type of mechanism of communicating.Cleft vaginal process (embryonic disturbances) occurs for many reasons:
also hydrocele may occur as a result of constant high intra-abdominal pressure that accompanies a number of pathological processes:
secondary hydrocele testes or reactive hydrocele, for which in most cases is characterized by unregulated development mechanismmay occur in the following cases:
Dropsy testicular received a classification in several directions.
Depending on how open or closed the vaginal canal, distinguish:
Depending on the pressure of the fluid in the scrotum:
Depending on the process flow:
without the need to treat an acute process can easily become chronic.
Depending on the reasons:
Most often parents reveal dropsy during the hygienic measures.Can detect the disease and the surgeon during routine inspection of the baby.The child is a condition often do not bother, no pain, no discomfort.
most common symptoms of hydrocele can be called the increase in the scrotum on one or both sides in size and cyanosis of her skin.Swelling in the groin area may indicate a hernia or other co-morbid conditions.
When injury occurs scrotal pain, while secondary hydrocele infection occur more severe symptoms:
reported hydrocele can resize and tension during the day, while the isolated hydrocephalus increases gradually.
is especially dangerous when the disease occurs in adolescence.Boys often shy to tell their parents about their problems and lead to the development of disease complications.
Diagnosis of hydrocele is not too much trouble, and consists of several stages:
This inspection is carried out in standing and lying, as it will help you understand what type of hydrocele is communicating or isolated.Typically, in a prone position communicating hydrocele is reduced in size.On this form may indicate hydrops and its increase during coughing, as there is increased intra-abdominal pressure.
Liquid is always good light transmission, while the tumor or gland, and part of the intestine with the inguinal-scrotal hernia will detain him.
hydrocele treatment method depends on the nature and causes of the disease.
Physiological dropsy simply observe.This waiting game, as the children under one year of hydrocele could pass on their own.Thus the only thing that is required of the parents - a warning colds and digestive disorders as sneezing, coughing and vomiting caused a sharp jump in intra-abdominal pressure.This, in turn, contributes to a rush of liquid in the scrotum.
When purchasing hydrocele should first carry out treatment of the underlying disease that caused the disease.
Thus, when post-traumatic hydrocele to relieve swelling and pain show non-steroidal anti-inflammatory drugs (Dolar, Fanigan, Ibuprofen, Movalis, Paracetamol, Diclofenac, Nurofen, etc.), And for infectious - a non-steroidal anti-inflammatory drugs, a further antivirals or antibiotics (Augmentin, Flemoksin, tsiprinol, Abaktal et al.).
edema in isolated operation carried Winckelmann, or Lord Bergman (if the child is older than 12 years), as well as a puncture.On the scrotum in place projection dropsy incision, egg output through the wound out, aspirated liquid and dissect the tunica vaginalis.
In step Winckelmann this shell turn inside out and stitch.Then all the liquid will be absorbed produced surrounding tissues.Further, all sewn in layers, the wound is a small rubber drain to drain the blood.
When Bergman operation, which is carried out at a hydrocele large and thick shells, processus vaginalis simply excised from its inception, and the remnants sheathe special seams.Then egg sinks back into the scrotum, and all layers sutured, and the wound remains small drainage.
Unlike the two previous operations, the operation of the least traumatic Lord, because they do not want to display the egg into the wound.Consequently, not injured testicle surrounding tissue and blood vessels.The very simple corrugated tunica vaginalis and sutured.
reported dropsy treated with the Ross operation, in which the wiring neatly bandaged processus vaginalis in the internal inguinal ring and cut.Then in the tunica vaginalis is formed an opening for the outflow of fluid from the scrotum.
Operation posttraumatic hydrocephalus shows after 3-6 months after the injury, but until then you only need to observe.At this time, sometimes a reducing (reduced in size) hydrocele.
Indications for surgery before the age of two:
tense edema is treated only by surgery.And the sooner the better.This condition requires a puncture, which resulted in all of the liquid is removed.But it does not guarantee that the effusion appears again.
Surgical treatment of congenital hydrocele is carried out in 1.5-2 years.It is only necessary if the edema persists for a long time.The greater its size, the operation must be done quickly.
child should be healthy, recovering from colds and other diseases take some time (but not less than one month), so that the body become stronger.Before the surgery, you must pass a general analysis of blood and urine tests, and six hours before surgery little patient can not eat anything or drink.
technical operations difficult.Calibration is done under general anesthesia (although intervention under local anesthesia, the doctor is easier to control), and the possible introduction of additional pain medication into a vein.During the operation, it is sure to controlled breathing and heartbeat.It lasts about forty minutes and can be performed on an outpatient basis.Immediately after surgery the wound for two hours put ice bag, whereupon the physician carefully places the suspensory bandage suspensory.
A few hours later the child already will be let go with my mother home.In the evening the kid can have a drink and a little later to eat.
Due to general anesthesia in a child is not in the form of emotional stress tools strangers in white coats and a strange smell.Also, there will be and unpleasant memories of the procedure.
Transient symptoms of pain and discomfort, it is best to eliminate the conventional NSAIDs, such as ibuprofen or paracetamol.
after each diaper change suture is recommended to treat with antiseptic (Chlorhexidine, Betadine, etc.).
If the wound stitches of non-absorbable material, a week to go to the doctor and take them off.
next check-up child must go through a month.
avoid postoperative complications mother should strictly comply with all recommendations of the surgeon.
easiest method of treatment.It is puncture dropsy and pumping fluid out of it.The effect of the treatment is very short, and always leads to relapse of the disease.
fairly new method of treatment in which the disease relapses do not exceed the threshold of 1%.The essence of this method is to remove the liquid from the shells and the introduction in its place sclerosing agents, such as Betadine or alcohol.They cause non-infectious (aseptic) tissue inflammation with subsequent coalescence that leads to the complete disappearance of the cavity where fluid accumulate.
When untimely begun treatment and chronically flowing process often develop complications:
Congenital hydrocephalus often goes alone.
Surgical competently performed surgery helps get rid of the disease and avoid complications.
In most cases, when time begun treatment the prognosis is favorable.This hydrocele does not affect reproductive function in the future.
Preventive measures are to prevent inflammatory diseases and injuries of the genitourinary system.A regular inspection of the genital organs parents of the baby.But with teenagers would be appropriate to carry out a delicate conversation about the disease in order to avoid numerous, often irreversible complications.