Features of development of a hydrocele in a young child and its treatment
Hydrocele in a child (Hydrocele) is characterized by uni - or bilateral enlargement of the scrotum due to fluid accumulation. Diagnose pathology the examination, the doctor, and the results of the decision which treatment is more applicable in this case: a waiting game or operation.
Causes of disease lie in the violation of lymphatic drainage, strong density of shell eggs and the suppression of good blood flow. As a consequence there is a slow (or, conversely, rapid) filling a liquid component between the shells, strong discomfort the boy feels.
Hydrocele in boys is more often a congenital defect (8-10%), but sometimes diagnosed with the acquired form, about 1% of cases. It is often combined with hernia in the groin, and often there are other anomalies – limfocele and paniculately. If the diagnosis is confirmed, immediate treatment (surgery).
Before the birth of the boy the vaginal lumen of the sheath should be closed, if this does not happen, there is a hydrocele or hernia in the groin is likely to need treatment.
Types of existing pathologies
There are specific varieties of disease, symptoms and pathogenesis cause further treatment.
This condition is observed when a poor fusion of the vaginal process, and sometimes the possible emergence of a "nesoobschaemost Hydrocele"; in this case, in the course of the spermatic cord are formed closed cavity when in the open lumen directs fluid fraction from the abdominal cavity in the shell of the egg.
The acquired form
Has two forms: idiopathic and symptomatic. Their development can begin at any age:
- Idiopathic. Often develops in a clear age-related changes.
- Symptomatic (reactive). Develops as a consequence of acute trauma of the inflammatory process, when there was any operation on the genital organs, tumors, heart failure.
Unlike idiopathic forms, jet is always associated with background disease, successful treatment which leads to resorption of the contents.
The mechanism of development
Hydrocele in boys under the age of three is due to birth trauma or difficult during pregnancy of the expectant mother. If the situation has not stabilized yourself, then developing secondary pathological condition which is caused by a disorder of the inner filter. Often doctors ascertain Hydrocele as a complication after colds or flu (adequate treatment required).
The reasons are entirely dependent on the type of hydrocephalus:
- Bad development of listapplet in infants or newborns.
- Open lumen of the vaginalprocess.
- Free circulation of fluid when opening the lumen of the abdominal cavity.
Causes of acquired forms:
- The inflammatory processes.
- Torsion of the testicles.
- Violation of lymphatic drainage, injury.
Features of clinical manifestations
Symptoms of dropsy in a child identify the primary or the parents, either during the inspection a pediatric surgeon. Self-diagnosis is visualization of the size of "bags".
- Increase the right or left of the bag" in size, sometimes double-sided magnification. Typically, swelling has sizes from chicken to goose eggs (sometimes reaches the size of a child's head).
- The possible decay of the tumor when communicating hydrocele in a child at night, and parents are faced with the illusion of recovery. This is due to the fact that the contents of the bag vodonosnogo "leaked" into the abdominal cavity. But in the afternoon, while the baby in an upright position, it again flows down. Usually, symptoms of hydrocephalus do not cause strong discomfort, acute inflammation is not observed.
- The symptoms of secondary infection Hydrocele: occurs redness "of the bags", the child has chills, fever, pain, vomiting, sometimes shortness of urination, and even acute urinary retention. Treatment should be immediate, with complex current need surgery.
How to recognize the disease?
Diagnosis of hydrocephalus is an important step towards the development of possible treatment options disease. If you notice even minor swelling of the scrotum, the child's parents should contact the doctor who will conduct a General examination of the baby, palpation in areas of concern, establish the cause.
Diagnosis is carried out in two postures: standing and lying. It is necessary to find out what form of hydrocephalus is present in the child (with or without message). In favor of communicating dropsy with abdominal cavity will speak volume reduction Hydrocele in the supine position. Palpation of the study, the edema has the appearance of a pear, where the upper part is addressed to the inguinal canal.
Diagnosis using non-invasive test ‒ the essence is the use of the diaphanoscope scrotum (transillumination), "the x-raying of the scrotum, the study of its tissues under a passing stream of light. In this type of diagnostics in the scrotum can be seen not only liquid, but a part of intestine, the omentum (with inguinal-scrotal hernia) that the flow of light will hold.
If in the process of identifying the causes of the disease required a more detailed diagnosis, prescribe ultrasound examination of the inguinal canals and scrotum. Using ultrasound confirmed/refuted the diagnosis and exclude more serious pathology (torsion, testicular cancer). Ultrasoundis a highly accurate method of diagnostics, allowing to determine the type of hydrocephalus, if necessary, appoint and uzdg vessels of the scrotum.
Differential diagnosis necessary to exclude such pathologies as a cyst of the epididymis and testicular torsion, strangulated hernia. Their symptoms are different from those of dropsy.
When causes and symptoms is established, until one year of age (congenital form) is used expectant management. It is often justified, but with reactive edema will require the identification of the causes, symptoms and treatment of the underlying pathology. When tense edema boys hold the puncture Hydrocele with complete removal of the liquid, however, this procedure is rarely single.
Surgery is indicated at the age of no earlier than 1.5-2 years with edema due to traumatic injuries – after 3-6 months after injury. Surgery for a child under 2 years is only when symptoms of concomitant pathology when the cause of dropsy is in close connection with inguinal hernia, as well as the presence of symptoms of infection and rapidly growing hydrocele.
Operation Winckelmann is done in a child older than 12 years, evidence ‒ unreported hydrocele. In cases of the message is performed a Ross procedure, when carried out the ligation of the peritoneal process and artificially formed path for the outflow of liquid.
If you do not set the causes and treatment of hydrocele leads to atrophic changes and subsequent disruption of spermatogenesis. In this case, an adult male is infertile.