What You Need To Know About Hydrocele
Hydrocele is a collection of fluid between the testicular capsule and its outer covering. It may be present on one or both sides and could be congenital or acquired.
The testis develops inside the abdominal cavity in a foetus. At birth or shortly after (which may be up to three months), it migrates downwards to reach the scrotum. The communication between the scrotum and abdominal cavity closes once the testis is in the scrotum. But at times, this closure may take longer or be incomplete and when this happens, some of the abdominal fluid leaks into the peritesticular space, thus resulting in congenital hydrocele.
This is a result of Inflammation of the layer covering the testis. This results in fluid secretion to counter and dilute the inflammation. However, in many cases, no obvious cause is found and this is known as idiopathic hydrocele.
Generally, small hydroceles are harmless but when the hydrocele increases and grows to a large size, it may obstruct movement or sexual activity. Hydrocele is a benign disease and fortunately, does not develop into cancer. However, it may be a cause of subfertility.
In young children, hydrocele is usually associated with an inguinal hernia. Surgical connection should be done beyond three months of age, since it interferes with the growth of the testes. This surgery is done by inguinal approach and closure of the opening with herniotomy is all that is required. In adults, the indications for surgery are as follows:
- Rapidly increasing hydrocele
- Large hydrocele
- Cosmetic reason
- In association with other scrotal surgery
- Symptomatic hydrocele
This involves incising the sac and then plicating the open sac to the sides of the testis all around. The space is obliterated, hence no more fluid can accumulate. This procedure is good for small hydroceles.
Incision And Eversion Of Sac (Jabolay’s Procedure)
In this technique, the sac is cut longitudinally and then everted. The two cut edges are then sutured behind the testis, thus obliterating the dosed space where fluid could collect. This procedure is particularly useful for large hydroceles.