Case Of Hydrocele Research Articles

Mapping lymphatic filariasis morbidities in 24 endemic districts of Ethiopia through the health extension program.

The primary strategy for achieving the second goal of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is morbidity management and disability prevention (MMDP), aimed at alleviating the suffering of affected populations. A significant challenge in many LF-endemic areas is the effective registration and identification of individuals with LF, which is crucial for planning and ensuring access to MMDP services. This study seeks to map the geographical distribution of LF-related morbidities across 24 endemic districts in Ethiopia. A community-based cross-sectional study was conducted to identify individuals affected by LF in 24 endemic districts using primary health care units (PHCUs). The study involved 946 trained health extension workers (HEWs) conducting house-to-house visits to identify and register cases of lymphedema and hydrocele, with support from 77 trained supervisors and 87 team leaders coordinating the morbidity mapping. Certified surgeons performed confirmatory evaluations through clinical assessments on a randomly selected sample of cases to validate HEW diagnoses, ensuring accurate identification of lymphedema and hydrocele. Statistical analysis of the data, including the severity of lymphedema and acute attacks, was conducted using STATA 17. This study involved 300,000 households with nearly 1.2 million individuals, leading to the identification of 15,527 LF cases-14,946 (96.3%) with limb lymphedema and 581 (3.7%) with hydrocele. Among those with lymphedema, 8396 (54.1%) were women. Additionally, 13,731 (88.4%) patients resided in rural areas. Of the 14,591 cases whose acute attack information was recorded, 10,710 (73.4%) reported experiencing at least one acute attack related to their lymphedema in the past 6months, with a notable percentage of males (74.5%; n = 4981/6686). Among the 12,680 recorded cases of leg lymphedema, the percentage of acute attacks increased with severity: 64% (n = 5618) mild cases, 68% (n = 5169) moderate cases and 70% (n = 1893) severe cases. This study successfully mapped the geographical distribution of LF morbidities across 24 LF-endemic districts in Ethiopia, identifying a substantial number of lymphedema and hydrocele cases, particularly in rural areas where healthcare access is limited. The findings underscore the potential of Ethiopia's health extension program to identify affected individuals and ensure they receive necessary care. The findings inform targeted interventions and access to MMDP services, contributing to Ethiopia's goal of eliminating LF by 2027.

Hydrocele in infants: surgical evaluation

Introduction: Hydrocele in infants is a condition characterized by fluid accumulation in the scrotum, often seen in newborns. This disorder, although often benign and self-limited, may require evaluation and, in some cases, surgical intervention. Understanding the factors associated with hydrocele, its clinical presentation, and therapeutic approach are essential to ensure appropriate management. The medical literature discusses the prevalence and implications of hydrocele, as well as guidelines for surgical evaluation in persistent cases, highlighting the importance of early identification and timely intervention. Methodology: The research followed the PRISMA checklist guidelines, using databases such as PubMed, Scielo, and Web of Science. Five descriptors were used: "hydrocele," "infants," "surgical evaluation," "treatment," and "clinical outcomes." Inclusion criteria included articles published in the last ten years, studies focused on infants, and that addressed the surgical evaluation of hydrocele. Conversely, exclusion criteria included non-systematic reviews, articles that did not specifically address the pediatric population, and studies with incomplete data. Results: The analysis revealed that most cases of hydrocele in infants resolve spontaneously, but surgery is recommended in cases of persistent or symptomatic hydrocele. The literature highlighted the importance of careful clinical evaluation and consideration of the risks and benefits of surgery. The main outcomes observed included surgical complication rates and parental satisfaction with the results. Conclusion: Hydrocele in infants requires a careful approach, taking into account both the often self-limiting nature of the condition and the potential associated complications. Surgical evaluation should be performed carefully, based on clinical guidelines and the experience of the medical team. The systematic review highlighted the importance of an individualized approach to each case, ensuring better outcomes for patients and their families.

A comparative ultrasound evaluation of two cases of prenatal and postnatal hydrocele

A comparative ultrasound evaluation of two cases of prenatal and postnatal hydrocele

Usefulness of indocyanine green in the laparoscopic Palomo technique: a comparative study.

To find out whether the use of indocyanine green for lymphatic sparing in the laparoscopic Palomo technique reduces the incidence of postoperative hydrocele. A comparative cohort study of varicocele patients treated with the laparoscopic Palomo technique from 2008 to 2023 was carried out. Patients were divided into two groups according to whether fluorescence lymphography (intratesticular indocyanine green) had been performed or not. Epidemiological, surgical, and clinical data, as well as complications, were recorded. A hypothesis test was conducted using the SPSS software. 30 patients undergoing varicocele surgery through the laparoscopic Palomo technique were included. They were divided into two groups -lymphatic sparing (n=13) vs. spermatic vessel ligation without sparing (n=17). Mean age at surgery was 14 years. 5 cases of postoperative hydrocele were identified in the no lymphatic sparing group. 1 of them required surgery for hydrocele treatment. No hydrocele cases were noted in the lymphography group. The difference was statistically significant (p=0.032). There were no statistically significant differences in terms of operating times or mean hospital stay. No recurrences, postoperative testicular atrophies, or indocyanine-green-related complications were recorded. Mean follow-up was 11.4 months. The use of indocyanine green for lymphatic sparing in the treatment of varicocele through the laparoscopic Palomo technique significantly reduces the incidence of postoperative hydrocele.

Occurrences of Hydrocele of Children During 1st 3 Months of 1402 Year in Balkh Regional Hospital

Introduction: Hydrocele defined by collection of fluid around the testicle between testicle & tunica vaginalis. Its common in children & adults, many peoples may affect by this disease every year. Its occur approximately at ratio of 1:10 in children’s after birth. Untreated cases should result to infertility, orchitis, epididymitis and finally testicles atrophy. Incidental averages are different from 6% to 30% by human kinds. All of male persons from birth to dying may affect by hydrocele. Method: this is a prospective and descriptive study which data collected by inspection, evaluation & assessment of patients who were examined and become bedded in Balkh regional hospital mazar e Sharif during 1st 3 months of 1402 year. The all collected data analyzed by specific statistical method (SPSS). Aim: occurrences of hydrocele according to age & sex during 1st 3month of 1402 year. Results: this study was performed over 1496 patients who come to Balkh regional hospital and bedded. From bedded patients, 893 case were males and remaining 601 case were females. 156 patients (17.5%) of bedded male had hydrocele and remaining 737 case (82.5%) were bedded during other diseases. From 156 hydrocele cases; 76 case (48.7%) seen in adults and other 80 case (51.3%) were children (ratio 100:95). Among 76 bedded adult patients who had hydrocele, 22cases were operated successfully and others treated none operatively by various reasons. Among 80 cases of children who had hydrocele, 35 patients operated & other treated none operatively. Hydrocele consist 8.9% of male bedded patient and include 0.9% of all referral patients in Balkh regional hospital Mazar e Sharif during 1st 3month of 1402 year. Otherwise, from male bedded patients, hydrocele include 17.5% that 8.5% were adult and 8.9% were children. 28.9% of adult patients were operated & 71.1% treated none operatively (the ratio 1:2.5). 43.7% of children that had hydrocele operated successfully & remaining 56.3% were not operating (ratio were 1:1.3). the right sided hydrocele was more seen in group of 6-10 year (14 case /40%), and lowest were 11-15 aging group (10 case of 35 case). Conclusion: Hydrocele is a disease which commonly seen in children and adults. It can affect individuals in any age. Hydrocele more commonly seen (16.3%) in 11 year of age and then in 3 and 8 age also common. Occurrences are approximately same in children and adults. Right sided hydrocele is funded 2 time more than left sided hydrocele. 69% of 35 cases were seen within inguinal hernia.

Laparoscopic inguinal hernia repair in children: true herniotomy is more reliable than herniorrhaphy

BACKGROUND: The optimal laparoscopic technique for pediatric inguinal hernia continues to be discussed with a view to its further refinement. AIM: This study aimed to ascertain the outcomes of two laparoscopic fully intra-corporeal techniques employed in our practice: herniorrhaphy and true herniotomy. METHODS: A retrospective comparative review of patient outcomes was conducted following laparoscopic groin hernia repair: herniorrhaphy — 1st series and true herniotomy — 2nd series. Patient data was analysed using non-parametric statistics with Mann-Whitney test. RESULTS: In total there were 328 patients, aged between 2 months and 17 years, with 402 groin hernia defects including metachronous and rare defects. The herniorrhaphy was performed for indirect hernia defects (n=186) and herniotomy — for indirect (n=206) as well as for direct (n=6) and femoral (n=2) defects. Technically, there were no intraoperative complications in any case in either series. Conversion to open procedure was required in one patient of 1st series (0,5%) with giant hernia because of the impossibility to maintain due pneumoperitoneum. The postoperative recovery was prompt and uneventful with restoration of mobility and oral intake within 3–6 hours in all patients with no difference between the series. Adverse postoperative events were noted in 10 patients after herniorrhaphy — hydrocele (n=6; 3.2%) and hernia recurrence (n=4; 2.2%) whereas after herniotomy there was only one case (n=1; 0.5%) of hydrocele and none of recurrence. The overall rate of these complications was significantly lower in the herniotomy series vs herniorrhaphy (p=0.004). CONCLUSION: Laparoscopic intracorporeal techniques both herniorrhaphy and true herniotomy are safe and effective for pediatric hernia repair. True herniotomy appears to be a more robust technique to minimise incidence of postoperative hydrocele and recurrence.

Comparing different lymphatic filariasis patient estimate approaches and results in Ethiopia

BackgroundThe World Health Organization (WHO) recommends that countries ensure morbidity management and disability prevention (MMDP) services are available to all lymphedema and hydrocele patients in lymphatic filariasis (LF)-endemic areas. The first step in ensuring the availability of MMDP services is to understand the number and distribution of people with lymphedema and hydrocele. We examined the burden of lymphoedema and hydrocoele using different patient estimation approaches employed in endemic districts of the Beneshangul-Gumuz and Tigray regions of Ethiopia.Methodology/principal findingsIn Approach I, trained health extension workers (HEWs) conducted the patient estimates during a door-to-door pre-mass drug administration (MDA) census. Validation of a sample of the data collected was integrated with a post-MDA coverage survey. In Approach II, trained HEWs conducted a stand-alone patient estimation, and clinical officers validated all suspected patients. In 15 districts, 753,557 individuals were surveyed. A total of 1,645 lymphedema (1:1.6 male-to-female ratio) and 517 hydrocele cases were identified. The prevalence of lymphedema and hydrocele was 40 per 10,000 in the adult population and 25 per 10,000 in the adult male population, with wide variation across districts. Validation in Approach I showed that 94% of the lymphedema cases and 77% of hydrocele cases were correctly identified by the HEWs, while 60% and 53% were correctly identified in Approach II.Conclusion/significancePatient estimation is important for planning, prioritization, targeting interventions, and monitoring progress in LF-endemic areas. Trained HEWs can correctly identify most cases using a standardized patient estimate job aid and questionnaire, even when cascade training is used. For the purposes of LF elimination, these results are sufficient and at a low cost per district. Ethiopia’s LF program could integrate patient estimations into MDA activities in the remaining LF-endemic districts with minimal cost and effort.

(224) The Use of an Acellular Dermal Matrix for Peyronie’s Plaque Excision and Grafting

Abstract Introduction The optimal surgical approach for severe Peyronie’s disease (PD) and the ideal grafting material are debatable. Acellular dermal matrices (ADM), among other graft materials that have been reported in the literature, are ideal candidates for graft choice due to the ability to retain structural integrity during the healing process and low immunoreactivity levels. Their use remains novel and only a few small studies have described outcomes of ADM grafting for PD. Objective The current study reports on the largest cohort of patients in the literature undergoing PEG with ADM (FlexHD Pliable). Methods After IRB approval, we reviewed the medical records of all patients undergoing PEG with Flex HD Pliable at our institution between the period of 2014 to 2023. A total of 52 patients with PD underwent PEG with FlexHD Pliable graft, with or without simultaneous inflatable penile prosthesis (IPP) insertion. Preoperative urological assessment of plaque was undertaken using penile color duplex ultrasound (PNUS) and degree of angulation and calcifications were recorded. All patients underwent surgery by a single surgeon. Results Patient’s age was 59.1+/-8.4 (43 to 81) years old. Dorsal curvature was recorded in 46.2% of patients, 23% had lateral, 13.5% had ventral and 17.3 % of patients had a combined curvature. Average penile curvature was 61+/-16 degrees (range 30-90 degrees). Hourglass deformity was recorded in 29.4% of cases; plaque calcification was confirmed on PNUS. The mean time between onset of curvature and surgical treatment was 25±37.9 months (range: 1-204 months). 19.2% patients failed intralesional treatment with Xiaflex prior to surgery and 4% had prior surgical treatment. In 75% of cases, simultaneous IPP placement was performed and in 25% of cases we performed PEG with FlexHD Pliable grafting only. Mean operative time for PEG was 114±22 minutes and simultaneous IPP placement prolonged the average operative time to 147±38 minutes. The average defect size was 21±8.3 cm2 (range: 4-48 cm2). A complete curvature correction was achieved in 90.4% and 9.6% had an average residual curvature of 11.25 °±4.8° (range: 5 ° -15 °). Eight patients (15.4%) reported postsurgical complications. Among them, two patients (3.8%) with altered penile sensation. One patient reported absence of sensation at the tip in the right mid glans; a decreased sensation at the ventral part of the penile shaft was recorded in the second case. There was one case of reactive hydrocele following IPP placement (2%) and five patients (9.6%) developed hematomas: 2 subcapsular graft hematomas required needle aspiration under PNUS guidance, a left spermatic cord hematoma and two penile hematomas that resolved spontaneously. Recurrent curvature onset was recorded in 4 patients (7.7%), but only 2 (3.8%) required re-operation. None of the patients suffered from infection-related complications. Conclusions Our results demonstrate the largest experience with ADM grafting for PD in the literature. PEG with FlexHD Pliable is a safe alternative to other commercially available grafting materials with a low complication rate. In the absence of a gold standard treatment for PD grafting materials, FlexHD Pliable is a practical and valuable option for this surgery. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Irrimax.

Filarial Epididymo-Orchitis – A Case Report

In an endemic country like India, the occurrence of filariasis is very common, especially in the states of Uttar Pradesh, Bihar, Jharkhand, Odisha, Andhra Pradesh, and Tamil Nadu. We present a case of a 50-year-old male with scrotal swelling. The patient had a history of trauma before a month. The sonography report suggested the possibility of hematocele. During histopathological examination, it was diagnosed as epididymo-orchitis caused by an adult filarial worm (Wuchereria bancrofti). From this, it can be concluded that the possibility of parasitic infestation as a differential diagnosis should be kept in mind when encountering cases of hydrocele, hematocele, or epididymo-orchitis.

Laparoscopic assisted trans-scrotal orchiopexy versus traditional orchiopexy for inguinal cryptorchidism: a retrospective study based on 154 patients

BackgroundThe purpose of this study was to investigate the clinical effect of laparoscopic assisted trans-scrotal orchiopexy versus traditional orchiopexy for inguinal cryptorchidism.MethodsA retrospective analysis of cryptorchidism patients who were admitted to our hospital from July 2018 to July 2021. The patients were divided into the laparoscopic assisted trans-scrotal surgery group (n = 76) and the traditional surgery group (n = 78) according to the surgical method.ResultsAll patients were successfully operated. There was no significant difference in operation time between the laparoscopic assisted trans-scrotal group and the traditional group (P>0.05). Although there was no significant difference in the postoperative hospital stay between the two groups, the time of postoperative hospital stay of the laparoscopic assisted trans-scrotal surgery group was lower than that in the traditional surgery group (P = 0.062). Additionally, there was no significant difference in discharge rate on the first day after surgery between the two groups, but the discharge rate on the first day after surgery was more than 90% in both groups. In terms of postoperative complications, there were no cases of testicular retraction, testicular atrophy, inguinal hernia, or hydrocele that occurred in both groups. There was no significant difference in the incidence of scrotal hematoma between the two groups(P>0.05). Although there was no significant difference in the incidence of poor wound healing between the two groups(P>0.05), the incidence in the laparoscopic assisted trans-scrotal surgery group was lower than that in the traditional surgery group (2.6% vs. 6.4%).ConclusionLaparoscopic assisted trans-scrotal surgery is as safe and effective method as traditional surgery for patients with inguinal cryptorchidism, and could also provide a good appearance.

Review of Vaginal Hydrocele Surgery in Lumbini Provincial Hospital over a Period of Five Years

Vaginal hydrocele is one of the common reasons for surgical outpatient consultation. Surgery for vaginal hydrocele i.e. eversion of vaginal sac (EVS) is common elective intermediate operation mostly performed under local anesthesia. The aim of this study is to share vaginal hydrocele surgery in Lumbini Provincial Hospital (LPH), Butwal. This is a retrospective analysis of vaginal hydrocele surgery done over a period of five years (2012 to 2016) in LPH, Butwal was done after the approval from Hospital ethical committee. All required information was retrieved from the medical record section. Total 164 vaginal hydrocele surgery was done for different sizes during the study period. The number of cases increased in 2016 because of free hydrocele surgery programs conducted by government of Nepal was well informed to ordinary people. The age distribution of the operated patients was 15 years to 92 years and common in productive age (21-60 yrs) i.e. 78%. Most of the hydrocele surgeries were done under local anesthesia i.e, 129 (78%). Most common complications found post operatively were 2.5% haematoma, 7.5% surgical site infection (SSI), 10% scrotal oedema and 2% recurrence. In our study chylocele was found in 10 (6/9%) cases of hydrocele. No testicular malignancy and tuberculosis of epididymis found during study period. No fatality cases during our study period. Vaginal hydrocele surgery is one of the common intermediate and mostly day care elective surgery done under local anaesthesia with relatively satisfactory outcome in LPH, Butwal.

Hydrocele of the Nuck canal

The process vaginalis in the inguinal canal forms the canal of Nuck, which is a homolog of the process vaginalis in women. Incomplete obliteration of the vaginal process causes an indirect inguinal hernia or hydrocele of the canal of Nuck, a very rare condition in women. A hydrocele of the Nuck canal, although rare, should be considered in the differential diagnosis in girls with inguinal swelling. Establishing a definitive diagnosis on physical examination is difficult, radiological imaging can help diagnosis, but surgical exploration is essential for the final diagnosis. The authors report a case of congenital hydrocele in a 2-year-old girl and review the literature on this rare entity whose diagnosis can be made by surgical exploration.

Diagnosis of Testicular Torsion and Differentiation From Other Pathologies Using Near-Infrared Spectroscopy

ObjectiveTo develop a near-infrared (NIR) spectroscopy device to diagnose testicular torsion with high sensitivity and specificity. Specifically, we aim to investigate the differentiation between testicular torsion from other pathologies such as orchidoepididymitis, varicocele, and hydrocele. MethodsTwo LEDs with wavelengths of 660 nm and 940 nm were used as light sources in the device. Each wavelength was sent to the testicle successively, and a photodiode detected back-reflected diffuse light. The ratio of the light intensities of 660 nm and 940 nm was used as a diagnostic parameter. A multi-center clinical trial was performed in 5 different hospitals. ResultsIn total, 62 patients in urology clinics with acute testicular pain have been recruited for the study. The developed NIR spectroscopy correctly defined all 8 testicular torsion cases. Besides, 3 orchidoepididymitis, 1 varicocele, and 3 hydrocele cases were correctly distinguished from testicular torsion. Only 1 hydrocele case was misdiagnosed as torsion. The range of the ratio was between 0.14 and 1.16 overall measurements. The ratio varied between 0.14 and 0.3 for the testicle with torsion. The ratio was between 0.49 and 1.16 for the normal testicle and testicle with other pathologies mentioned above. ConclusionWe have chosen the threshold ratio of 0.4 to differentiate between the normal and torsion testis and diagnosed all the torsion cases among all normal and other pathologies. The developed optical device to diagnose testicular torsion is inexpensive, user-friendly, and works based on objective criteria with high sensitivity and specificity in real time.

Comparison of the size of bilateral testis in children with unilateral non-communicating hydrocele and its correlation with age.

Opinions on the optimal age for surgical management of hydroceles in young boys are not uniform. Scrotal ultrasonography can be used to diagnose hydroceles and measure testicular size. A comparison of bilateral testicular size with hydrocele and the change in trend with age has not been reported. We therefore aimed to analyze the bilateral testicular size of children with unilateral non-communicating hydroceles and examine the correlation between age and testicular volume. Non-communicating hydrocele cases in children were included. Ultrasound results, age, and diagnose time were retrospectively recorded. The bilateral testicular size was compared, and the correlation between age and testicular volume was analyzed. There were 138 cases of non-communicating hydrocele, ranging in age from 11 to 72 months. The diagnose time ranged from 3 days to 54 months. The volume of the testis on the side of the hydrocele was larger than that on the normal side (P < 0.001). Testicular length was not different bilaterally. Testicular width and height were greater on the hydrocele side than on the normal testicular side (P<0.001). Age was positively correlated with testicular volume on the normal side (P = 0.004) but not on the hydrocele side. An important finding was that when the contralateral normal testicular volume increases with age, the testicular volume does not increase on the hydrocele side. This finding confirms the adverse effects of hydrocele on testicular growth and provides a basis for early treatment.

A case of unilateral hydrocele in a dog secondary to inapparent inguinal hernia

A 6-year, male intact Coonhound, was presented for unilateral scrotal enlargement of roughly 3 months’ duration. His left side scrotum was markedly enlarged and edematous and both testes palpated normal. Rapid slide agglutination test (for brucellosis) and SNAP 4DX (IDEXX Laboratories, Inc., Westbrook, ME) test (for tick-borne disease) were negative. Initial scrotal ultrasonography revealed accumulation of anechoic fluid with hyperechoic flecks and swirling surrounding the left testis. On further ultrasonographic examination, omentum appeared extending through the left inguinal ring and into the scrotum. A case of scrotal hernia with secondary hydrocele was diagnosed. Hydrocele was resolved surgically and the dog returned to full athletic function.

CHARACTERISTICS OF UROLOGY PATIENTS TREATED BY STICHTING SAMENWERKING VLISSINGEN-AMBON (SSVA) IN HAULUSSY HOSPITAL 2017-2018

Introduction. BPH, Urolithiasis and UTI are often urology cases found in Indonesia. There is no epidemiological data about Urology Patients in Maluku Province. Some patients in the province were handled either through referral to other cities or rely on charity program (SSVA) because there was no Urologist available yet in the province. Aim. To understand the characteristics of urology patients treated by SSVA in Maluku Province, including age, gender, and diagnosis. Method. This descriptive study used retrospective data from the medical records of patients treated by the SVVA in Haulussy Hospital from 2017–2018. Results. From a total of 281 (100%) urology patients, there were 173 (61.65%) benign prostatic hyperplasia (BPH) cases, 52 (18.50%) nephrolithiasis cases, 20 (7.11%) urinary tract infection cases, 13 (4.62%) hydrocele cases, 9 (3.2%) vesicolithiasis cases, and 5 (1.77%) varicocele cases. The largest number of BPH patients was from 60-69 years old age group with a total of 71 (41.04%) patients, followed by 70-79 years old age group with a total of 45 (26.01%) patients. From a total of 52 nephrolithiasis patients, there were 28 (53.48%) male patients and 24 (46.15%) female patients, and according to patient age, the largest number was from the 40-59 years old age group with a total of 31 (59.62%) patients, followed by the 60-79 years old age group with a total of 11 (21.16%) patients. Conclusion. The largest number of urology patients treated by the SVVA were BPH patients, followed by nephrolithiasis and urinary tract infection patients. The age group that suffered the most from BPH are those aged 60-69 years. In nephrolithiasis patients, it was found that male patients were slightly more prevalent than female. The age group that suffered the most from nephrolithiasis are those aged 40-59 years.&#x0D; Keywords: Characteristics; Urology

Outcomes after eversion of sac and subtotal excision of sac in cases of primary hydrocele

Background/Aim: Hydrocele is a common disease worldwide, and an effective treatment for it is surgery. The commonly performed procedures for its treatment are a) excisional technique — subtotal excision of the sac and b) Jaboulay’s procedure — eversion of the hydrocele sac. This study aimed to evaluate the merits and demerits of eversion of the sac versus subtotal excision in terms of complications, postoperative hospital stays, and recurrence rate. Methods: This prospective study was conducted at a large surgical center. Patients who presented with scrotal swelling and were diagnosed as primary hydrocele cases constituted the study population (100 in all). Subtotal excisions or eversions of the sac were performed depending on the type of hydrocele encountered preoperatively. Follow-up was done at 1week, 1 month, 3 months, and 6 months postoperatively. Results: Eversion of the sac was done in 70 cases, and subtotal excision was done in 30 cases. Incidence of edema, intense pain, and hematoma formation was higher in the group undergoing excision of the sac compared to those undergoing eversion of the sac. The average postoperative hospital stay was 3–5 days in the eversion group. The average postoperative hospital stay was 7–9 days in the subtotal excision group. No recurrence was noted in either of the study groups during the stays study period. Conclusion: Eversion of the sac was associated with fewer postoperative complications, minimal tissue handling, and good hemostatic control compared to subtotal excision of the sac. Patients who underwent eversion of the sac received earlier discharge than those undergoing a subtotal excision of the sac for primary vaginal hydrocele.

Laparoscopic management of infantile hydrocele in pediatric age group

PurposeTo evaluate laparoscopic management of hydroceles in pediatrics, with evaluation of the internal inguinal ring (IIR) and the PPV (patent processus vaginalis) in different types of hydroceles, and the incidence of the contralateral PPV.MethodsThe IIR and the type of hydrocele on the same side of 93 patients with 106 infantile hydroceles were evaluated and managed, in addition to contralateral side.ResultsThe IIR on same side was closed in 8.5% (Type I) and patent in 91.5% (Type II and III) with different shapes. Contralateral IIR was open in 88.7% of cases. The operative time was 30.99 ± 7.23 min, with no intra-operative complication. The vas deferens and testicular vessels were secured and there were no injuries or bleeding. The conversion rate was zero, and all procedures (Type II and II) were completed totally laparoscopic. No post-operative complications except a case of tense hydrocele developed scrotal edema that managed conservatively.ConclusionLaparoscopic hydrocelectomy is safe, applicable and feasible for management of different types of hydroceles in pediatrics. The IIR is patent in nearly all cases with/out communication to the hydrocele. The contralateral IIR can be managed in the same session. Laparoscopic hydrocelectomy with/out hydrocelectomy and IIR closure is essential in preventing recurrence.

Minimal dissection technique vs Jaboulay’s procedure for small to moderate size hydrocele – A retrospective study

Abstract: Hydrocele is one of the most common disease of the male, with incidence of 1 in 1000 cases. Primary hydrocele is of idiopathic origin and secondary hydrocele are caused by infection or tumours. Surgery is the gold standard treatment. This retrospective study was conducted to determine the advantages of minimal dissection technique vs. Jaboulay’s procedure in small and moderate size hydrocele. Methods and Materials: In this study 86 cases of hydrocele were included and divided in two groups. In group I, minimal dissection technique was done and in group II, conventional Jaboulay’s procedure was done. The two groups were compared with regard to operation time, hospital stay, return to work, recurrence and other results. Post-operative complications noted. Categorical data were statistically analyzed. Results: The study showed better results in respect of operative time, hospital stay, return to work, patient satisfaction in patients in minimal dissection group when compared with patients in the conventional Jaboulay’s procedure. Conclusion: Hydrocelectomy is considered the gold standard technique for the treatment of hydrocele and the minimally dissection technique provide the best operative outcomes regarding scrotal edema and hardening and patient’s satisfaction when compared to conventional eversion-excision hydrocelectomy.

A Clinical Study of Scrotal Swelling and its Various Treatment Modalities

Aim: To study the etiology, clinical presentation, investigations, treatment modalities &amp; their outcomes, post operative complications for scrotal swellings and follow up. Materials and Methods: The cases admitted to the surgical wards over a period of one and a half years i.e., November 2018 to May 2020, formed the material for this study. During this period 100 cases with h/o scrotal swelling admitted in various surgical units, selected at random were studied in detail as per proforma. Sampling Method: A Simple Random Sampling Results: 100 cases of scrotal swellings were studied and compared based on age, occupational distribution, mode of presentation, duration of symptoms, predisposing factors, treatment modalities and post operative complications. Conclusions: Scrotal swelling was commonest symptom. The other symptoms included pain/ heaviness of scrotum, fever, etc. • Definitive surgery was done in 90 cases. • Various forms of hydrocele constituted a major portion of the study (50 cases). • Varicocele was the second commonest cause comprising of 13 cases. • A total of 9 cases of Fournier”s gangrene, 6 cases of torsion of testis including one with scrotal abscess. • There were 09 cases of epididymo-orchitis, 4 cases of testicular tumor, 3 cases each of sebaceous cyst and encysted hydrocele of cord and 2 cases of hydrocele with hernia. Keywords: Treatment modalities; Scrotal swellings; Hydrocoele; Varicocele; Outcome.