Causes of testicular edema in men
A testicle testicle in men occurs with accumulationliquid in thin sachet formation in the scrotum around the testicle. The disease is manifested by a painless increase in the size of the scrotum on the diseased side due to a violation of the outflow of the produced fluid.
A dropsy, or hydrocele, often develops with oneside of the scrotum, but it is possible and bilateral fluid accumulation. Congenital dropsy occurs in approximately 10% of boys and 1% of men over 40 years of age.
At the same time, most of them have a diseasepasses independently for 1 year. The second peak in the incidence of men is the age of over 40 years. In this case, the disease occurs due to inflammatory diseases and scrotal injuries.
In the absence of timely treatment hydrocele can progress for years, taking huge dimensions (10 cm in diameter or more).
According to the statistical data on morbidityhydrocele in the UK, 99% of patients with hydrocele were hospitalized in specialized hospitals, 9% of whom needed emergency care. The average length of stay in the hospital patient with dropsy was 1.9 days. 43% of patients are men from 15 to 59 years old. The average age of patients hospitalized with a diagnosis of "dropsy testis" was 39 years.
Although the mechanism of the development of the disease is not fully understood, it is proved that the accumulation of fluid in the scrotum occurs due to a violation of its outflow. There are the following possible causes of dropsy in men:
- Infectious diseases
- Injury of testis
- Edema of adjacent organs and lower extremities
All these states are accompanied by a complete orpartial occlusion of the excretory ducts responsible for maintaining the normal amount of fluid in the scrotum, and lead to excessive accumulation and stagnation. The risk factors for developing dropsy include:
- Operative interventions on the organs of the perineum and the effect of ionizing radiation (radiotherapy).
- There are data linking ascites (congestionfluid in the abdominal cavity) with edema. This is possible with a congenital or acquired anomaly of the duct that connects the abdominal cavity with the scrotum. In this case, in the course of operative treatment of dropsy, correction of this duct is carried out.
Symptoms of dropsy in men havenot expressed character and in most cases are absent. The accumulation of fluid inside the testicles proceeds painlessly and leads to a gradual increase in the size of the scrotum. In a number of cases, the volume of the accumulating fluid may increase spasmodically (in acute inflammatory diseases or in the early postoperative period).
An increase in the scrotum with dropsy can reach 10 centimeters or more in diameter, which leads to:
- to occurrence of difficulties at walking, an emiction, sensation of gravity
- such patients note the discomfort of having sex
- to the touch the scrotum becomes dense, with a perceptible splash of fluid inside the membranes, painful sensations, palpation does not cause
- a characteristic feature of the hydrocele is the inability to determine the contours of the testicle because of the increased accumulation of fluid.
In severe infectious diseases, exudatecan be subjected to suppuration, which leads to the development of piocele. This condition is considered a complication of dropsy and is manifested by a sharp deterioration in the patient's condition, an increase in body temperature and the spread of inflammation to the surrounding tissues. At the same time, painful sensations in the area of the inflammatory focus are often noted.
In addition to piocele, the lack of timely treatment can cause such consequences of dropsy as:
- Pressure of the testicles. This condition leads to testicular atrophy and reproductive failure
- Bleeding as a result of a vascular injury with the development of hematocoel (a clump of blood between the testicles)
- Rupture of membranes due to overexertion with excessive accumulation of fluid
- Development of a scrotal hernia
With the development of a condition such as dropsyin men, treatment is aimed at eliminating the causes and effectively preventing complications of the disease. Any medical manipulation is performed by a doctor only after the necessary examination. During the diagnosis, the doctor will necessarily evaluate a number of tests to exclude concomitant diseases and to conduct differential diagnosis with a scrotal hernia.
One of the rapid methods of confirming the diagnosisis diaphanoscopy. The essence of this method is to pass the bright light through the enlarged part of the scrotum. Since the liquid does not contain any impurities or foreign bodies at the hydrocele, the light passes through the tissues freely, thereby confirming the diagnosis.
Nevertheless, the main diagnostic criterion,on the basis of which the final diagnosis is made, is an ultrasound that allows an accurate assessment of the anatomical structures of the scrotum and the volume of fluid inside the testicles.
When detecting dense formations or uncharacteristic for hydrocele impurities, additional research may be needed for oncological diseases or inflammatory processes of the inguinal organs.
Treatment of dropsy testicles in men
Treatment does not necessarily require surgery: A dropsy of testicles in men can pass independently in the absence of a provoking factor. To this end, it is necessary to determine precisely the cause of the development of the disease and to exclude its further impact.
If the cause of dropsy is epididymitis oranother inflammatory disease, the treatment is aimed at eliminating inflammatory manifestations and fighting infection. Such patients are prescribed a course of antibacterial drugs and non-steroidal anti-inflammatory drugs.
With a testicle injury accompanied by swellingsurrounding tissues, therapeutic measures are aimed at normalizing blood and lymph circulation to improve the outflow of fluid. Often the hydrocele passes independently without additional interventions. If ineffectiveness of the manipulations performed or the severity of the symptoms of the disease increases, the patient is shown the surgical treatment of dropsy. For this purpose, apply:
There are several operational techniques, amongwhich are the most common methods proposed by Winckelmann and Bergman. These are simple surgical interventions performed under regional anesthesia. During surgery, the surgeon cuts the scrotum or lower abdomen, after which the condition of the canal connecting the abdominal cavity with the scrotum is evaluated and the hydrocele is removed. During the operation, it may be necessary to install a drainage tube to prevent postoperative recurrence of dropsy. This tube is removed after a few days. Cold is also used topically to reduce swelling.
- Puncture aspiration of fluid
This manipulation involves removingaccumulated fluid through a needle inserted into the scrotum. This method was not widely used, since it has a temporary effect and does not provide complete recovery of the patient. To increase the efficiency after aspiration of fluid in the needle, a sclerosing drug is introduced, which makes it possible to reduce the amount of the produced liquid. This method is used to treat patients who have severe contraindications to surgical treatment.
If the puncture is incorrect, the testicles canserious complications in the form of bleeding or infection with the development of inflammatory diseases. In surgical treatment, the risk of vascular damage to the testicle is reduced, as the surgeon performs a careful visual control and corrects the size of the incision, based on the state of the tissues in the area of intervention.
The recovery period does not require a longmonitoring the patient's condition. Patients who underwent surgery for hydrocele can lead their old life, without functional limitations, almost immediately after treatment.
Immediately after surgery, the patient is transferred to the wardobservations, where an assessment of its vital indicators is made and the state of the postoperative wound is monitored for bleeding. The statement is made on the day of the operation with recommendations for monitoring at home.
Control append is appointed after a fewweeks after the operation to assess the healing of the wound in the dynamics and to exclude its infection. Swelling of the tissues can persist for several months after the removal of hydrocele. If there is a worsening of the patient's condition, an increase in body temperature, redness in the area of the operation, it is necessary to immediately consult a doctor.
The prognosis of the course of dropsy in men is favorable. In most cases, the disease passes by itself. Postoperative relapses are very rare and occur only in the treatment of large hydrocele.
The risk of infection during the operation does not exceed 2%. Nevertheless, a possible complication is trauma to the spermatic cord, accompanied by a violation of the reproductive function.
In most cases, the operation has a positive effect, completely eliminating the defect of the membranes and preventing the development of relapses.
Return to a fulfilling life occurs infor 10 days after the operation, although hard labor and sexual activity are prohibited for a period of 4-6 weeks. There are no data on the fatal outcome associated with surgical treatment of hydrocele.
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