Newborn baby with large testicles

If a newborn baby has large testicles, it may be caused by hydrocele. It is best to go to a regular professional hospital for relevant examinations. After the diagnosis is confirmed based on the examination results, symptomatic treatment should be given. Parents must pay more attention to observing the baby and try not to let the baby cry violently. Once the baby's testicles show abnormalities, timely treatment must be carried out to avoid worsening of the condition.

Hydrocele is common in newborns, but usually resolves spontaneously by the time the baby is 6 months old. If an older child suddenly develops a hydrocele, it may be caused by trauma. A hydrocele may be associated with an inguinal hernia and may require surgery. An older child who develops a hydrocele suddenly should also be diagnosed by this doctor. A hydrocele may get better on its own without treatment. However, you will still need to undergo examinations including ultrasound scans to rule out the possibility of testicular injury.

Diagnosis and examination of hydrocele: In a relatively dark place, shine a flashlight on the swollen scrotum. If it is clear and translucent, it means there is scrotal hydrocele. If it is not translucent, it may be a hernia or a testicular tumor, which requires further diagnosis. Ultrasound examination can help diagnose and differentiate between a tumor and edema.

Most children's hydrocele will be absorbed and healed on its own before the age of one. If the child is over one year old, the chance of self-healing is very slim. You should get treatment at this time. Treatment options include surgical intervention and drainage of the accumulated water.

Surgery: Use surgery to enter from the groin, find the sheath leading to the scrotum and ligate it, drain the accumulated water, and then perform distal excision of the sheath tissue. If an adult only has simple scrotal hydrops, a scrotal incision can be made and a scrotal hydrops resection can be performed.

Draining the accumulated water: Some people also use injections of sclerosing agents after draining the water, but the effect is not obvious and it is easy to relapse and inflame, so you should choose carefully. It is especially inappropriate for children because the processus vaginalis of the inguinal region is not completely closed, which may cause peritonitis.

1. Scrotal wall lesions

1. Scrotal edema is caused by scrotal allergy (angioneurotic edema caused by insect bites), inflammation, contusion, tumor compression of the inferior vena cava reflux or systemic diseases (such as heart failure and nephrotic syndrome, severe ascites, cachexia, etc.), which lead to excessive accumulation of water in the scrotal wall tissue. The manifestation is obvious enlargement of the scrotum, disappearance of wrinkles, translucency and luster, and obvious depression without tenderness when pressed. If accompanied by inflammation, there may be tenderness and congestion.

2. Scrotal elephantiasis This is a clinical manifestation of urogenital filariasis. Parasitic filarial worms block the lymphatic vessels in and around the scrotum, causing lymphatic return to overflow and stimulating the proliferation of fibrous tissue in and under the skin of the scrotum, causing elephantiasis. The symptoms include rough scrotal skin, extremely thickened cortex and subcutaneous tissue, which are not easily indented when pressed. The skin of the penis is also often affected, causing the penis to sink inward and disappear. Another type is due to the accumulation of lymph fluid, which makes the scrotal skin moist. In severe cases, lymph fluid can be seen dripping continuously, which can lead to secondary infection and the formation of ulcers, eczema, etc. Acute lymphangitis is often accompanied by fever and local redness, swelling and pain. This disease is common in areas where filariasis is prevalent, and microfilaria can be found by checking peripheral blood smears at night.

3. Erysipelas is caused by inflammatory lesions of the lymphatic network on the scrotal skin, which causes the skin to become congested, edematous and tender. The boundaries of the affected skin are clear and it is often accompanied by systemic symptoms such as fever and chills.

4. Scrotal cellulitis or gangrene is an acute infection of scrotal cellulite. The scrotum suddenly becomes congested, swollen, and painful. In severe cases, the scrotal skin becomes hard and darker, forming gangrene. Sometimes there is a crackling sound when pressed, and there is a special odor. It is often accompanied by toxic blood symptoms such as chills, high fever, nausea, vomiting, etc. Bacteriological examination of wound exudate shows mostly mixed infection of hemolytic streptococci, Pseudomonas aeruginosa, Staphylococcus aureus and anaerobic streptococci.

5. Urinary extravasation If there is a history of urethral bladder trauma or urethral fistula, urine may leak into the scrotal cellulite, which is manifested by obvious swelling of the scrotum, pale skin, disappearance of wrinkles, and a translucent and shiny scrotum, with obvious depression when pressed. Urgent treatment is required, otherwise secondary infection may occur.

6. Scrotal skin cancer can be primary skin cancer or metastatic cancer. The local skin lesions become thicker and harder, shrink and sink, and radial wrinkles appear around them, which may be accompanied by ulcers. A biopsy may be done to confirm the diagnosis.

2. Scrotal contents

(I) Sheath lesions

1. Hydrocele can be caused by inflammatory tuberculosis, tumor, trauma or filarial infection. Generally, the course of hydrocele is slow, the swollen scrotum is cystic, with elastic fluctuation, and the translucency test is positive. The type of hydrocele can be determined by the shape and location of the scrotal swelling and whether it disappears when lying down. The hydrocele of the testicular passage is pear-shaped, smooth, elastic and cystic to the touch; in the case of communicating hydrocele, the swollen scrotum may gradually become smaller or even disappear when examined in the supine position; the hydrocele of the spermatic cord is located higher, above the scrotum. Large hydrocele may affect walking and labor but is painless. Because the mucus wraps the contents of the scrotum, the testicles and epididymis cannot be touched. If secondary vaginal mucus is suspected, the testicles and epididymis can be carefully examined after puncture and suction of the accumulated fluid.

2. Hemocele Due to trauma or tumor erosion, blood may accumulate in the cervical cavity. The transillumination test is negative, and bloody fluid can be aspirated by puncture.

3. Inflammatory exudate can cause pyocele to manifest as obvious local tenderness, negative transillumination test, and often fever.

4. Chylocele is caused by filariasis and may be accompanied by other signs of filariasis. The scrotum is cystic and non-tender. The radiolucency test is negative, and chylous fluid can be aspirated by puncture.