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Gidrotsele (edema of covers of testicles)
Gidrotsele (Greek "hydor" — liquid and "kele" — swelling), or an edema of covers of testicles represents a disease at which liquid accumulates between leaves of covers of a small egg. Usually the volume of the saved liquid makes several milliliters, but can reach also 2,5-3 l. An edema of covers of testicles happens inborn and acquired. Inborn to a gidrotsela generally occurs at children, and acquired — at young men aged till 30 flyings.
Not fusion of a vulval shoot of a peritoneum on which liquid from a peritoneum gets to a scrotum is a basic reason of an inborn disease. Usually within the first year of life of the child the shoot of a peritoneum grows, liquid in a cavity of a cover of a small egg resolves, following, why self-healing follows. If it does not occur, then forms not reported (simple) inborn to a gidrotsela, not connected with an abdominal cavity in any way.
Acquired to a gidrotsela happens primary or idiopathic and secondary.
Primary to a gidrotsela disturbance of balance between liquid which cosecretes and absorbed by a small egg cover is basic reasons.
As the reasons secondary to a gidrotsela inflammatory diseases of both the small egg, and its appendages, and also various injuries of a scrotum and a crotch, disturbance of outflow of a lymph from a scrotum act.
At acute inflammatory processes in testicles and appendages (epididymite), or against other diseases, such as tuberculosis, gonorrhea, can arise reactive, "symptomatic" to a gidrotsela which passes after treatment of a basic disease. Also the inflammation of covers of testicles can be shown and as complication after treatment to a varikotsela.
Symptoms to a gidrotsela
Most often the acquired dropsy develops after injuries. In several weeks in one of half of a scrotum there can be a painful tumor which increases gradually, broken a lymph drainage. Such process can continue several years, and then a chronic edema of covers of testicles is formed.
In a chronic form to a gidrotsela it is not shown by pain. The main symptoms to a gidrotsela are increase in the struck half of a scrotum, sometimes morbidity and discomfort can be also observed when walking. Accumulation of liquid happens gradually, and presents itself a swelling in the form of the pear turned by the basis down. If the swelling gets to the pakhovy canal, then takes the form of hourglasses.
To the touch an edema smooth is also dense, can be painful at a palpation. If an edema reaches the big sizes, then it can create difficulties at an urination and at sexual intercourse. The patient can feel an acute pain when there are complications to a gidrotsela against inflammatory diseases of a scrotum. More rare option of a disease is to a gematotsela, the hemorrhage resulting from a serious injury, and representing in a cavity to a gidrotsela. The empyocele – a pyocele meets as complication of an inflammation of epididymes, an orchitis.
Diagnosis to a gidrotsela
Difficulties at diagnosis of an edema of covers of testicles usually do not arise. At a palpation during primary survey, the doctor finds slightly painful dense education, at the same time the small egg and its appendages are not palpated. At a diafanoskopiya of a scrotum uniform raying of all education is observed, but only if there are no complications in a look to a gematotsela and a pyocele. Diagnosis the gidrotsela by means of ultrasonic research of bodies of a scrotum can establish precisely the diagnosis since from the increased half of a scrotum liquid accumulation is visible. If acquired to a gidrotsela is complication at other diseases, for example, at a tumor of a small egg, then ultrasonography allows to establish the reasons of its emergence precisely.
Treatment to a gidrotsela
The main method of treatment of an edema of covers of testicles is surgical intervention. If at the child 1 years are more senior the vulval shoot of a peritoneum does not grow, then operation of an alloying of this shoot is performed. If an edema is a consequence of other diseases, at first carry out treatment of a basic disease.
For removal of liquid from a cavity of an edema appoint a puncture during which liquid is removed, and the sclerosing drugs are administered. This operation often is followed by complications, such as entering of an infection in a cavity to a gidrotsela, or damage of a cover of a small egg that leads to hemorrhage and accumulation of blood in an edema cavity.
Treatment to a gidrotsela is carried out by radical methods. 2 types of surgeries – Vinkelmann's operation and Bergman's operation which is carried out under local anesthesia are generally applied. At Bergman's operation the part of an internal leaf of a cover of a small egg is removed and its rest is sewed. Vinkelmann's operation represents a section of one of small egg leaves on a front surface, its reversing inside out and sewing together behind a small egg. After carrying out these operations of accumulation of liquid does not occur.
Complications to a gidrotsela
The main possible complications to a gidrotsela is development to a gematotsela and a pyocele. It should be noted that an edema of covers of testicles extremely negatively influences a spermatogenesis, and can lead to infertility.