Hydrocele PPT.pptx

Hydrocele

1. HYDROCE L E Dr. J. N. SENAPATI Professor Department of Gen Surgery IMS & S UM Hospital

2. Definit I on A Hydrocele is an abnorma l collection of serous fluid in a part of the processus vaginalis , usually the tunica vaginalis .

3. TYPES OF HYDROCELE Primary Secondary

4. PRIMARY HYDROCELE ? Congenital Vaginal Infantile Hydrocele of the cord

5. SECONDARY HYDROCELE ? Causes :- Epididymorchitis Torsion Tumor Post herniotomy

6. Characterstics of secondary hydrocele ? Lax Moderate size Testis palpable

7. CHARACTERSTICS OF HYDROCELE FLUID ? Amber colour Specific gravity – 1.022 – 1.024 Water, salts , Albumin, Fibrinogen Cholesterol and tyrosine crystals

8. Conditions in which we cant get above the swelling ? Congenital hydrocele Infantile hydrocele

9. Can hydrocele present as purely inguinal swelling ? YES Encysted hydrocele of the cord.

10. Conditions in which hydrocele presents as inguinoscrotal swelling ? Congenital hydrocele Infantile hydrocele

11. Can hernia present as purely scrotal swelling ? Herniation of hydrocele through dartos muscle.

12. SWELLING WHICH REDUCE ON LYING DOWN ? Reducible Hernia Varicocele Lymph varix Congenital hydrocele

13. Hydrocele in females ? Hydrocele of the canal of nuck.

14. Conditions in which there is loss of testicular sensations ? Syphilitic gumma Lepromatous orchitis Advanced testicular tumor

15. SWELLINGS SHOWING CROSS FLUCTUATION ? Plunging ranula Compound palmar ganglion Psoas abscess Hydrocele en bisac (Bilocular hydrocele)

16. SWELLING WHICH ARE BRILLIANTLY TRANSILLUMINANT ? Vaginal Hydrocele Epididymal cyst Cysto hygroma Ranula Meningocele

17. ABSENT TRANSILLUMINATION ? Pyocele Hematocele Spermatocele Chronic hydrocele

18. INTERMITTENT HYDROCELE ? Congenital hydrocele

19. Role of ultrasonography ? Testis not palpable ; Vaginal hydrocele. Palpable but suspicious Acute hydrocele

20. How will you differentiate between inguinal hernia and encysted hydrocele of the cord ? Traction test Reducibility Impulse on coughing

21. COMPLICATIONS Pyocele Hematocele Testicular atrophy Rupture Herniation of hydrocele sac Infertility

22. Treatment Congenital hydrocele – Herniotomy Acquired - VAGINAL HYDROCELE – Small size – Lord’s Operation Moderate size – Jaboulay’s Operation Large size – Excision of sac + Jaboulay’s operation Very Large size – Scrotoplasty + Excision of sac + Jaboulay’s operation

23. How to differntiate between hematocele and testicular malignancy ? HEMATOCELE History of trauma present Long duration Non progressive swelling Weight loss absent Surface smooth Testicular sensation present Lymph node absent MALIGNANCY History of trauma absent Short duration Progressive swelling Weight loss present Hard / Variable surface Testicular sensation absent Lymph node present

24. THANK YOU