At what age is surgery suitable for hydrocele

Hydrocele is a disease that many children will have. Many parents may not know about it. Some children's hydrocele will be absorbed by itself after the age of two. This is of course the best situation and no additional treatment is needed. If the child cannot absorb the hydrocele on his own, then surgical treatment may need to be considered. Let us take a closer look at hydrocele surgery.

The tunica vaginalis, which is derived from the peritoneum of the process vaginalis when the testicle descends, has a secretory function. The serosal surface of the tunica vaginalis can secrete fluid, which can be absorbed at a constant rate through the spermatic vein and lymphatic system. When the secretion increases or the absorption decreases, the fluid accumulated in the tunica vaginalis sac exceeds the normal amount and forms a cyst, which is called hydrocele.

Congenital hydrocele is caused by patent processus vaginalis. Incomplete closure of the processus vaginalis in different parts can form various types of hydrocele. Sometimes it may be accompanied by a palpable inguinal hernia. Regardless of whether a hernia exists or not, there are potential factors for hernia formation.

Surgical procedures

(I) Anesthesia and body position

1. Anesthesia is ketamine combined anesthesia.

2. The body position is supine with the head low and feet elevated at 150 degrees.

(II) Surgical procedures

1. Incision and artificial pneumoperitoneum: A 0.4 cm small incision is made on the umbilical fold, and a pneumoperitoneum needle is inserted to inflate the abdomen. Then a hole is made to insert a micro-laparoscope. A 0.3 cm small incision was made 3 cm beside the left umbilicus, and a hole was made to insert the operating forceps.

2. There are three forms of the internal ring of hydrocele seen under the exploratory microscope.

(1) 57% internal ring opening ￠0.3～0.7cm (equivalent to the internal ring opening of a small oblique hernia): When squeezing the scrotum and spermatic cord mass, it can be seen that all the accumulated fluid flows back into the abdominal cavity from the internal ring opening. All lumps in the scrotum and spermatic cord can disappear.

(2) 38% of the internal ring openings are ￠0.2-0.4cm and are in the shape of a fish mouth. When squeezing the scrotal and spermatic cord masses, the accumulated fluid can be seen flowing back into the abdominal cavity from the fish mouth in the form of dripping water, and the scrotal and spermatic cord masses may disappear completely or partially.

(3) 4% had a small depression at the inner ring opening: when squeezing the scrotal and spermatic cord masses, a cyst-like object could be seen protruding into the depression, but no accumulated fluid flowed back into the abdominal cavity, and the scrotal and spermatic cord masses did not shrink or disappear.

3. Suture the inner ring opening. Make a 0.15 cm small incision in the skin at the projection of the inner ring opening on the affected side. Insert the needle with thread from here to suture the inner half circle of the inner ring opening. The thread is brought into the abdominal cavity. The needle with thread is withdrawn from the abdominal cavity. Then insert the hook needle from this incision to suture the outer half circle of the inner ring opening. Hook the abdominal suture and bring it out of the abdominal cavity. At this time, the inner ring opening is formed into a purse-string suture, the thread is tightened and tied under the skin, the inner ring opening is closed, the pneumoperitoneum is relieved, and the operation is ended. The incision does not need to be sutured.

4. For those who still have fluid accumulation in the scrotum and spermatic cord, puncture can be used to extract the fluid and then inject 20 mg of prednisolone acetate.

If the amount of hydrocele is large, surgery is necessary. Laparoscopic surgery is safer for children. Find a large hospital where the doctors are experienced and there will be no problems. Don't worry. It is better to perform hydrocele surgery at the age of 2 years old!

What are the surgical steps for hydrocele of the spermatic cord? I believe that many patients, including parents, have fully understood the steps of this operation. Therefore, after fully understanding it, in order to get rid of the harm of this disease to their bodies as soon as possible, they must go to a large hospital as soon as possible and undergo surgical treatment to recover from this disease as soon as possible, so that their bodies can be healthier.