Ross's operation with a testicle is often performed in children under two years old. The disease affects the genitals for various reasons. Before performing a surgical procedure, consult a specialist. The purpose of this intervention depends on the factors that affected the appearance of pathology. There are also risks of such impact, which must be taken into account.
Characteristics of the pathology
Pediatric epididymis affects the male genital glands. The disease is often diagnosed in infants immediately after birth. In some cases, the pathology manifests itself in sexually mature men. A dropsy is characterized by fluid accumulation under the testicular capsule. The capsule is necessary for performance of protective properties. In a healthy state, under the shell is a small amount of fluid, which helps to reduce the overheating of the testicles. This is necessary for normal spermatogenesis. The temperature in the scrotum is always several degrees below the body temperature. If the liquid interlayer increases, the risk of overheating increases. It is accompanied by death of germ cells and testicular atrophy.
Hydrocele is present in infants with intrauterine growth. The male glands are formed in the abdominal region. At the time of birth or within a year after it, the testicles descend into the cavity of the scrotum. Also in the abdominal cavity a vaginal process is formed. It is a cavity that facilitates the accumulation of fluid under the testicle. If the vaginal shoot is retained when the glands are lowered into the scrotum, then dropsy develops. In this case, there is a transition of fluid from the abdominal cavity to the scrotum. Externally, the pathology is accompanied by the appearance of edema of the genital organs. The scrotum is hot and tense to the touch.
Pathology has two main forms:
- Congenital or communicable type;
- Acquired hydrocele.
Acquired form of dropsy develops in children and adults after birth. Its appearance is affected by various causes. The hydrocele can develop due to traumatic testicles, inflammatory lesions, infection of the genitourinary system. This form of the disease is characterized by fluid accumulation, which contains pus fibers, dead cells of the gonadal gland tissues and pathogens. Such pathology proceeds in an acute form, signs appear within 2-5 days. Rarely does body temperature rise, there is a febrile syndrome. If help is not provided in the first hours of the pathology, necrosis of the testicle is possible. The patient may lose the childbearing function. Conception is impossible.
The communicable type of hydrocele develops in young children up to two years of age. The disease is manifested due to the cavity of the vaginal process.
In the normal state after birth, the communicating hole between the peritoneum and the appendage grows throughout the year. But sometimes the tissue does not coalesce. The fluid that fills the abdominal cavity falls into the process. Between the testicle and the walls of the capsule a secret is accumulated. With prolonged course of the pathology, the amount of fluid increases. Externally, the child develops a swelling of the scrotum, glands are not palpated when palpated. Often the pathology passes independently, as the tissues begin to grow together against the background of age-related growth. In some infants, pathology persists.
If hydrocortis is accompanied by the development of additional signs, doctors recommend Ross's operation. This surgical intervention is the most successful operation for the treatment of hydrocele.
Indications for surgical intervention
Ross operation is prescribed only if there are indications for a man. Surgical treatment is necessary when there are signs such as:
- Strong increase in scrotal volume, which does not disappear during movement;
- Difficulty of movement due to enlarged glands;
- Congenital disease diagnosed in the hospital;
- With the development of concomitant complications;
- Severe pain in children older than 2 years;
- Risk of infertility.
With the communicating form of dropsy in children, a specific feature is observed. If the baby is put on his back, the liquid from the scrotum flows into the peritoneum. The volume of the inguinal sac decreases. If this does not happen, there is a danger of complications. In this case, the liquid is in the cavity and is fixed by the vaginal process. Ross's operation in this case is necessary on indications.
Surgical intervention is performed with difficulty in movement due to a large increase in glands. The scrotum becomes hot and swollen. The patient can not move normally due to discomfort. It appears when rubbing inflamed tissues about underwear. With this pathology, surgical intervention is indicated in boys over two years of age.
The main purpose of the Ross operation is carried out with a congenital pathology. In this case, the effect is carried out by the classical method. Permission for surgery should be given to parents.
Vodianka is accompanied by various concomitant diseases. Often internal organs can fall into the duct between the appendage and peritoneum. Babies develop a hernia. In this case, the intestinal loop enters the scrotum. With prolonged exposure in the scrotum, the duct increases, the length of the intestinal loop increases. The Ross operation is assigned during diagnosis. The lost time can affect intestinal atrophy and its removal.
Dropsy of the testis is rarely accompanied by pain. But if this syndrome manifested itself in young children, then surgical intervention is necessary. This sign indicates the development of atrophy of spermatic cord. If the impact is not timely, then the cord is torn, the testicle dies. An adult male with this problem has difficulty in conception. Infertility can appear and at an atrophy of testicles. The hydrocele affects the torsion of the testicles. This pathology can be eliminated only by surgery. If the medical effect is not performed in the first 24 hours, the sex gland is killed.
Prerequisites for preparation for surgical intervention
Ross operation is performed by two methods:
- Emergency;
- Scheduled.
Emergency treatment is performed with atrophy of the gonads, a sharp increase in the volume of the scrotum, an acute hernia. In this case, the patient should be over two years of age, not having concomitant diseases. A mandatory condition is the written permission of the parents.
Ross's planned operation is carried out after careful preparation. It helps to avoid the development of postoperative complications and to recover quickly. It is necessary to conduct immunostimulating treatment at least a month before the operation. The child is often prescribed medications containing interferon. Adults receive antiviral treatment. This is necessary to maintain a general positive state of health, since a frequent complication in the postoperative period is herpes rash.
One week before the operation, the patient must pass an analysis of urine and blood. Analyzes will help to establish whether the patient has concomitant inflammatory pathologies. Blood is taken to set the group membership.
Surgical effect is performed only on an empty stomach. This avoids the development of risks in anesthesia.
Ross operation is performed under general anesthesia. Anesthesia is given through a special catheter. To preserve the respiratory function, a special intubation tube is inserted into the larynx. If there is liquid or food in the stomach, it can enter the lungs through the tube. In this case, a lethal outcome is possible.
It is mandatory to check for hidden infections. Many bacterial diseases occur in a latent form. Clear signs they do not have. If, after surgery, the pathogenic microorganism enters the operating field, the risk of bacterial infection increases. If such an illness is detected during the examination, the patient needs additional antibacterial treatment.
How is the surgical procedure performed by
The Ross operation has certain characteristics. The guarantee of a positive outcome is the professional skills of specialists. Operative intervention occurs in three stages:
- Entering into anesthesia;
- Surgical intervention;
- Derivation from anesthesia.
Ross operation is performed under general anesthesia. This helps to avoid psychological trauma in the child. During the entire surgical influence the child is in deep sleep. He does not see strangers, rooms, does not smell medical preparations. The baby is already awake with her mother in the ward. Strong fright in this case is not observed.
Removal of dropsy is carried out through a small incision on the area of the scrotum. Tissue dissection is performed between the sex glands. On this site, the testicles, the funicles and the vas deferens can be clearly seen. Through the incision, the vaginal process extends to the surface. It is bandaged at the top and bottom. After careful bandaging, the process is excised. On the affected capsule, the surgeon leaves a small hole that will drain the liquid. It is equipped with a catheter or a small elastic band. The surface of the scrotum is sutured.
After this, the anesthesiologist introduces a special drug, through which the action of anesthesia passes. The patient comes to his senses. If a significant decrease in the volume of the scrotum and a normal outflow of fluid is observed in the patient, then an extract is performed. Further therapy is carried out at home.
Surgical treatment with hydrocele is an effective method of treatment. For a positive outcome, you must carefully follow the instructions of a specialist.
