Hydrocele Flashcards
what is a hydrocele?
Collection of fluid around the testicle, forming between the parietal and the visceral tunica vaginalis
etiology of hydrocele
majority are idiopathic
can be reactive, assoc. w/inflammatory conditions (ie. epididymitis, torsed appendix testis, resolves w/resolution of underlying condition)
How does a hydrocele present?
Unilateral scrotal enlargement
What important hx q’s should you ask?
gu trauma
prior hydrocele (tx?)
pain
degree of bother, interference w/ADL
What should you do on PE for a hydrocele?
palpation
translumination (from behind)
What diagnostic tool should you order?
scrotal ultrasound (more dense things = white)
hydrocele looks black
When should you Tx?
asxs = monitor
bothersome = elective tx
tx options
Needle aspiration, with injection of sclerosing agent
Hydrocelectomy
needle aspiration advantages/disadvantages?
Advantages: done in office, awake, with local anesthesia
Disadvantages: may recur
Complications of needle aspiration?
possible infection, bleeding (hematoma), pain
Describe the needle aspiration procedure
Local anesthetic for spermatic cord block
Needle placed into hydrocele sac
Fluid aspirated Sclerosing agent (ie. doxycycline) instilled into empty hydrocele sac
Hydrocelectomy advantages/disadvantages
Advantages: Not likely to recur
Disadvantages: Done in O.R. with anesthesia (outpatient). If Penrose drain, will need removal
complications of Hydrocelectomy
Pain, bleeding (hematoma), infection, poss loss of testis
Describe the hydrocelectomy procedure
Trans-scrotal incision made
Hydrocele sac opened and fluid aspirated
Opening enlarged, tunica vaginalis everted, marsupialized
Penrose drain may be sutured in place to drain scrotum overnight
