Urology

Pediatric tuberculosis in boys and adult men, treatment methods

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Dropsy testis - this pathology is often diagnosed in newborns, but it can also develop during the adult period. Despite the absence of pain, dropsy of the testicles not only causes aesthetic discomfort and physical inconvenience to the patient, but also is fraught with the development of serious consequences up to male infertility. That's why all swelling in the scrotum should be shown to the doctor without fail.

Contents

  • 1 Dropsy - what is it?
  • 2 Ovarian dropsy in a newborn baby boy
  • 3 Pediatric testis in a male
  • 4 Ovarian dropsy treatment
    • 4.1 Types of operations for ovarian dropsy

Epidemic dropsy - what is it?

An epididymis is a pathological condition in which a fluid accumulates in the testicles, more often than one. Disease, in medical circles called hydrocele, can develop at any age: from the period of newborns( congenital pathology) and ending with the mature age.

Dropsy of testis

The volume of accumulated liquid can vary from several ml to 1 liter or more. Absence of painful sensations causes the patient's inattention to a small swelling of the scrotum.

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This situation( chronic course) can last for years. However, over time, the soft tumor gradually increases in size, causing problems with urination and erectile function in men.

Pediatric testis in newborn boys is found in 10% of male infants and is most often associated with underdevelopment of the anatomical structures and the non-infection of the communication between the testicle and the abdominal cavity. This pathology often requires only observation of doctors up to 2 years.

Radical therapeutic measures are required for edema in adult men - in this case, surgery is often necessary.

Causes of acquired ovarian dropsy

Fluid accumulation in the testicular shell spaces occurs for the following reasons:

  • Scrotal injuries are one of the most common causes of dropsy in boys( active games, accidental falls, fights);
  • Inflammatory processes - tuberculosis, orchitis, epididymitis;
  • Venereal infections - gonorrhea, chlamydia( more than half of cases of dropsy in adults are caused by sexually transmitted diseases);
  • Filariasis - a violation of the outflow of lymph in the perineal region provokes the accumulation of fluid in the scrotum;
  • Operative interventions - hydrocele often occurs after kidney transplantation, surgical intervention with varicocele;
  • Urologic tumor formations( benign and malignant);
  • Disturbance of blood circulation in the scrotum due to excessive physical activity associated with lifting of gravity.

Symptomatic picture of dropsy depends on the age of the patient, the nature of the course of the illness( acute and chronic), the volume of accumulated fluid.

Ovarian dropsy in newborn baby

The main signs of dropsy in the baby are determined visually. Hydrocele is manifested:

  1. Pear-shaped enlargement of one or both testicles, with the possible spread of swelling in the inguinal region( swelling has the appearance of an hourglass);
  2. The affected part of the scrotum has an elastic consistency, its surface is smooth to the touch, the skin is not welded to the deep layers and is easily assembled into a fold;
  3. At palpation there is no soreness, non-intensive fluctuations are fixed;
  4. The displacement of the testicle downwards is determined only with insignificant dropsy, most often the location of the testicle is not determined.

It is worth remembering : both in small boys, and in men, the left testicle is located just below the right one!

A characteristic feature of the hydrocele in infants is that the size of the scrotum increases in the evening, the size of the affected testicle decreases after a prolonged sleep of the baby. Dropsy testicles in the period of newborn does not affect urination in any way.

Pediatric testis in men

The clinical picture of dropsy in adults is more diverse. In the acute course of the disease caused by sexual infection or trauma, against the background of increased temperature, the pain in the scrotum of the expanding character gradually increases.

For the chronic form more typical dull pain, sometimes aching. The dropsy of the testicle shells can then increase in size gradually or stepwise. Initially, swelling can be with a goose egg, and later without timely treatment, reaches the size of a newborn's head.

With a significant increase there is difficulty urinating and erection problems. The lack of treatment with prolonged flow of hydrocele in adults leads to a violation of spermatogenesis and threatens male infertility.

A testicular dropsy can be combined with a hemorrhage( haematocel).Especially often this is observed with a testicle injury, hemorrhagic diathesis, an unprofessionally performed puncture of ordinary dropsy.

In the infectious nature of the hydrocele, the accumulation of accumulated fluid is often recorded. For purulent dropsy is characterized by high fever, pronounced twitching pains, strong fluctuations when probing the scrotum, intoxication of the body.

Treatment of hydrocele

Treatment of oedemas

The therapeutic tactics of hydrocele depends on the cause and form of the disease. So, the congenital dropsy found in a preventive examination in a newborn does not require treatment, it is enough to observe regularly the pediatric urologist.

Only with a large volume of accumulated fluid and the resulting tension of the testicle shells is it punctured. Often, one procedure for removing fluid from the testicle space is sufficient to treat severe congenital dropsy.

Repeated interventions are extremely rare.

In case of post-traumatic edema, firstly, the integrity of the testicle should be excluded. Unrespended hydrocele, caused by trauma or inflammatory process, requires observation in the andrologist-urologist for 3 months.

The lack of improvement, the growth of painful symptoms necessitate the operative treatment of dropsy in men. In the dotted intercostal cavity, from which the liquid is pumped out, special substances of sclerosants are added, which prevent the repeated formation of dropsy.

  • Sclerotherapy of the water cavity practical eliminates the possibility of recurrence of the disease. The procedure should be performed by an experienced doctor in order to avoid hemorrhage and infection.

With organic urogenital pathology that caused dropsy, the main treatment involves eliminating the cause of the disease. If necessary, the course of antibiotic therapy.

Types of operations for ovarian edema

  • Ross operation - is suitable for congenital testicular edema caused by non-communication of the communication( abdominal process) between the celiac cavity and the intercostal space of the testicle. The abdominal process is then excised, and then the inguinal ring is bandaged.
  • The Bergman operation - is shown with an isolated hydrocele, the inner shell testicle is completely excised with subsequent tissue cross-linking.
  • Operation Winckelmann - is to dissect the front surface of one shell sheet, it is turned off by the sign and stitching behind the testicle.
  • The Lord's operation is the least traumatic intervention in terms of preserving the tissues surrounding the testicle and the vessels that feed it. Removal of water fluid is accompanied by the formation of corrugation of the vaginal membrane, which generates a lubricant fluid for the testicle. This type of surgery is not suitable for chronic dropsy with thickened membranes and large hydro-targets.

The type of surgical equipment is determined by the doctor already during the surgical procedure. Operation in the dropsy of testicles in men is often performed under local anesthesia, does not require long hospitalization( on average 1 day of the hospital) and powerful anesthesia during the postoperative period.

In the next 5 days, the patient is recommended to observe peace, wear a suspensions, in case of problems with bowel movement, mild laxatives are prescribed.

Obligatory condition of rehabilitation - 2 weeks you can not wear tight underwear, squeezing the scrotum.

Forecast

The hydrocele in newborn boys is usually eliminated by 1 year and does not give any complications. Chronic disease in adults and lack of effective treatment leads to irreversible atrophic changes in testicles and infertility.

More serious prognosis for edema caused by an inflammatory process. In such cases, puncture with pumping out the fluid often does not bring a lasting result and leads to more radical surgical intervention.

The most unfavorable prognosis is associated with dropsy, which developed against varicocele. Even after the operation, there are recurrences of dropsy due to stagnation in the lymphatic vessels.

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