Are there risks in surgery for hydrocele

When hydrocele becomes serious, it can no longer be treated with conservative measures alone. Surgical treatment should be chosen according to the patient's condition to achieve a cure. However, the course of this disease is relatively long, and many patients do not meet the conditions for surgery when they first develop the disease. Therefore, do not rush into surgery during this period to avoid risks.

1. Follow-up observation

It is suitable for patients with slow disease course, little fluid accumulation, low tension, long-term non-growth and no obvious symptoms. Infantile hydrocele often disappears on its own before the age of 2 and there is no need for urgent treatment. The effusion caused by systemic diseases can be gradually absorbed when the systemic diseases are cured.

2. Puncture and fluid extraction, injection of sclerosing agent treatment

Simple puncture and fluid extraction is prone to recurrence. After fluid extraction, a sclerosing agent is injected into the cervical cavity, and the connection between the cervical cavity and the abdominal cavity must be ruled out. Because of its complications such as local lump formation and secondary infection, its application is still controversial.

3. Surgery

(1) The vaginal sheath rotation is the most commonly used procedure in clinical practice. It is easy to operate and has good surgical results.

(2) Cystocele resection is mainly used for spermatic cord cystocele.

For communicating hydrocele, high ligation is performed at the internal ring opening, the unclosed processus vaginalis is cut off, and the hydrocele is flipped.

Based on symptoms and signs, the diagnosis of hydrocele is usually not difficult and should be differentiated from the following diseases:

1. Inguinal hernia

A mass can be felt in the scrotum or groin, and sometimes an intestinal shape can be seen and bowel sounds can be heard. The mass can be reduced when the patient is in the supine position (unless incarceration occurs). There is a feeling of impact at the inner ring when coughing, and the transillumination test is negative.

2. Testicular tumor

There is a solid mass in the scrotum with a hard texture. The testicle on the affected side feels heavy and like a weight when weighed. The light transmission test is negative.

3. Spermatocele

Located above the testicle, attached to the head of the testicle, it is mostly round and small in size, usually around 2 cm. The testicle can be clearly felt, and diagnostic puncture can extract a milky white fluid containing dead sperm.

4. Erosion of the vagina

Scrotal puncture can draw out fluid, which is usually light yellow in color. If caused by filariasis, the accumulated fluid may be milky white chyle.

5. Hemocele

If the hydrocele is caused by trauma or a bleeding disorder, the fluid is bloody or is entirely blood, and the transillumination test is negative.