Edema of the testicle, which occurs in men of different ages, has a second name – hydrocele. Pathology is formed due to various reasons, perineal trauma or the consequences of infectious inflammation leading to impaired fluid outflow and the formation of scrotal edema are considered to be leading. Progressive hydrocele can cause infertility in a man due to compression and overheating of the testicle. With the appearance of the slightest swelling, especially abruptly arising, it is necessary to consult a doctor and establish the cause of the lesion.
Hydrocele: fluid accumulation, testicular swelling
Acquired hydrocele occurs in men from about 18 to 45 years. The basis of the pathology is the accumulation of fluid in the cavity of the scrotum and between the membranes of the testicle, which leads to an increase in the size of the genitals. If the child’s form is typical of incoming edema, self-eliminating as it grows, then in adult males the hydrocele itself is not eliminated, it is prone to progression and complications, up to infertility.
Adult males usually suffer from acquired testicular edema, but the forms may be different. The lesion can be unilateral, when the edema affects one of the testicles, usually the right one, or bilateral. The course can be acute, abruptly occurring after provoking factors or chronic. The fluid that accumulates in the scrotum and leads to the formation of its edema can be non-inflammatory — it is usually lymph or intercellular fluid. Rarely as a result of injury, pathology develops due to accumulation of blood. If it develops inflammation, then an accumulation of inflammatory exudate or purulent contents forming the scrotum swelling is formed.
Causes of hydrocele: injury, infection, vascular defects
If we talk about the acquired hydrocele, then one of its leading causes is inflammation of the testicle itself or its appendages, which leads to increased production of exudate and its accumulation in the scrotum. The second most common cause is injury perineum or scrotum, including operative. Against the background of injuries, venous or lymphatic vessels can spasm or thrombate, draining fluid from this area, which leads to its accumulation in free space. More rare causes of hydrocele can be a violation of lymphatic circulation in the limbs and small pelvis, gonorrhea or tuberculous lesion, causing inflammation of the genitals.
There are also risk factors that can contribute to stagnation of fluid in the scrotum. These include sports or professional injury of the perineum, strikes to the groin area. Vascular and tissue injuries during surgery for varicocele or inguinal hernia, damage to lymph nodes, heavy physical exertion, and the formation of congestive heart failure can also contribute.
Manifestations: during and outside inflammation
Symptoms largely depend on the cause and type of pathology. Among the leading complaints – a sharp increase in the scrotum in size, somewhat decreasing after a night’s sleep. There is no pain in non-inflammatory forms of pathology, the skin is normal. Against the background of acutehydrocele, if it is provoked by inflammation of the testicle, acute pain and localized fever, fever, bilateral scrotal edema. Fluid may accumulate at one half, at the lower pole of the testicle, giving the pear-shaped scrotal area. Against the background of some variants of inflammation, there may be accumulation of fluid in the area of the inguinal canal and partially in the bottom of the scrotum. This forms an hourglass shape. A sharp increase in size leads to difficulty urinating, impaired sexual function. The doctor, when probing, notes the smoothness of the surface, the free gathering of the skin in the folds, the testicles are not felt in the liquid. If the cause was an injury, there may be bruising, a hematoma, a sharp pain.
How dangerous hydrocele: the development of infertility
Long-term current hydrocele leads to impaired blood flow in the testis and its appendages, as well as an increase in its temperature. This is unfavorable for spermatogenesis, which provokes infertility. In addition, the constant compression of testicular tissue by accumulating fluid leads to its atrophy, and then infertility may become irreversible. There is a certain influence on the circulatory disorders in the scrotum, which leads against the background of infertility to the addition of a violation of potency and ejaculation disorder, psychological discomfort.
What the doctor will help: diagnosis and treatment
Any changes in the size of the scrotum require a visit to a doctor – this may be a surgeon or a urologist. First of all, the doctor will ask about the circumstances of the occurrence of the anomaly, will examine the man in a standing and lying position, as well as make diaphanoscopy – transmission of the scrotum skin with a beam of light. This will confirm hydrocele and can help in determining the content (blood, inflammatory exudate, lymph). If an infectious nature is suspected, the doctor prescribes a number of tests, as well as an ultrasound of the scrotum and blood vessels.
Treatment of hydrocele in adult men is only operational, this condition itself does not tend to disappear. Do not touch only hydrocele, which is provoked by testicular inflammation until the process is completely resolved. In these cases, the doctor recommends wearing a supportive dressing and taking painkillers, anti-inflammatory drugs.
For all other cases of hydrocele, the tactics of the operation and the method of adequate pain relief are selected. It is possible to carry out minimal interventions using local anesthesia (usually epidural), with an opening of the cavity where fluid accumulates and its removal, carefully, in all spaces of the scrotum. Then the defect is sutured. At the time after the operation requires limitation of physical activity, wearing a bandage and the transition to lightweight mode. In rare situations, doctors may resort to puncture the testicle, removing excess fluid with a needle. But often relapses occur, so the measure is temporary, as long as it is impossible to conduct a full-fledged operation.