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    Hydrocele Varicocele

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    ﻣﻮﺩﻫﻴﺘﺎ ﻛﻮﺭﻧﻴﺎ ﺳﻴﺎﺭﻳﻔﺎ
    Hydrocele is defined as a collection of fluid within the tunica vaginalis of the testis. It can be congenital, primary, or secondary. Congenital hydroceles include communicating and infantile types. Primary hydroceles have an unknown etiology and may be due to an imbalance in fluid secretion and absorption. Secondary hydroceles are caused by infection, trauma, or tumors. Treatment involves tying off communicating processes, hydrocelectomy, or treating the underlying pathology. Varicocele is an abnormal dilatation of the veins of the pampiniform plexus and is a common cause of male infertility. It can be primary due to valve abnormalities or secondary to tumors. Treatment options include sper

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    Hydrocele Varicocele

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    ﻣﻮﺩﻫﻴﺘﺎ ﻛﻮﺭﻧﻴﺎ ﺳﻴﺎﺭﻳﻔﺎ
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    Hydrocele is defined as a collection of fluid within the tunica vaginalis of the testis. It can be congenital, primary, or secondary. Congenital hydroceles include communicating and infantile types. Primary hydroceles have an unknown etiology and may be due to an imbalance in fluid secretion and absorption. Secondary hydroceles are caused by infection, trauma, or tumors. Treatment involves tying off communicating processes, hydrocelectomy, or treating the underlying pathology. Varicocele is an abnormal dilatation of the veins of the pampiniform plexus and is a common cause of male infertility. It can be primary due to valve abnormalities or secondary to tumors. Treatment options include sper

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    Hydrocele is defined as a collection of fluid within the tunica vaginalis of the testis. It can be congenital, primary, or secondary. Congenital hydroceles include communicating and infantile types. Primary hydroceles have an unknown etiology and may be due to an imbalance in fluid secretion and absorption. Secondary hydroceles are caused by infection, trauma, or tumors. Treatment involves tying off communicating processes, hydrocelectomy, or treating the underlying pathology. Varicocele is an abnormal dilatation of the veins of the pampiniform plexus and is a common cause of male infertility. It can be primary due to valve abnormalities or secondary to tumors. Treatment options include sper

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    Download as PPT, PDF, TXT or read online from Scribd
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    Download as ppt, pdf, or txt
    43 views19 pages

    Hydrocele Varicocele

    Uploaded by

    ﻣﻮﺩﻫﻴﺘﺎ ﻛﻮﺭﻧﻴﺎ ﺳﻴﺎﺭﻳﻔﺎ
    Hydrocele is defined as a collection of fluid within the tunica vaginalis of the testis. It can be congenital, primary, or secondary. Congenital hydroceles include communicating and infantile types. Primary hydroceles have an unknown etiology and may be due to an imbalance in fluid secretion and absorption. Secondary hydroceles are caused by infection, trauma, or tumors. Treatment involves tying off communicating processes, hydrocelectomy, or treating the underlying pathology. Varicocele is an abnormal dilatation of the veins of the pampiniform plexus and is a common cause of male infertility. It can be primary due to valve abnormalities or secondary to tumors. Treatment options include sper

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 19

    HYDROCELE

    Defined as a collection of fluid within the


    tunica vaginalis of the testis

    CASSIFICATION
    1. Congenital
    2. Primary
    3. Secondary

    1. CONGENITAL
    Communicating (vogbreuk)
    Infantile
    Interstitial
    Cord

    2. PRIMARY HYDROCELE
    Idiopathic (aetiology not known)
    Imbalance between the fluid secretion and
    absorption of the tunica vaginalis

    3. SECONDARY HYDROCELE
    Infection
    Trauma
    Tumor
    Abnormalities in inguinal lymph nodes

    DIFFERENTIAL DIAGNOSIS:
    SCROTAL CYSTIC MASSES
    Indirect inguinal hernia
    Epididymis cyst
    Hydrocele
    Varicocele
    Spermatocele
    Piocele
    Hematocele

    TREATMENT
    Communicating
    Tying off the patent processus vaginalis
    Primary
    Hydrocelectomy
    Aspiration + injection of sclerosing agent
    Secondary
    Treat underlying pathology

    DIFFERENTIATION
    HYDROCELE

    Palpate cord
    above mass
    Translucent

    YES

    INGUINAL
    HERNIA
    NO

    YES

    NO

    Fluctuate

    YES

    NO

    Fluid thrill

    YES

    NO

    DIFFERENTIATION
    HYDROCELE
    Testis palpable

    NO

    INGUINAL
    HERNIA
    YES

    Cough impulse

    NO

    YES

    Reducible

    NO

    YES

    Bowl sounds

    NO

    YES

    FLUID ASPIRATED FROM


    CYSTIC MASSES
    SUPRA TESTICULAR
    CYSTIC MASS
    Cord hydrocele

    COLOR OF FLUID

    Spermatocele

    Milky or
    Grey opaque (barleywater)
    Clear

    Epididymis cyst

    Straw color

    VARICOCELE

    Defined as an abnormal dilatation and


    distension of the veins of the pampiniform
    plexus

    INCIDENCE
    15% in the general population
    (8% - 23%)
    16,3% in adolescents
    (12,4% - 25,8%)
    33% in infertile men
    (19% - 41%)
    58% - 93% left sided

    ETIOLOGY
    Abnormality of the venous valves
    Left spermatic vain joining the left renal
    vein directly at a 90 angle
    Longer left spermatic vein with increased
    hydrostatic pressure
    Pressure of superior mesenteric artery on
    the left renal vein (Nutcracker phenomenon)

    PRESENTATION
    Complaints of a scrotal mass
    (Bag of worms)
    Complaints of scrotal discomfort
    Fertility problems
    Incidental diagnosis with clinical
    examination
    Smaller left testis

    CLACCIFICATION
    Primary
    Abnormality of valves in the spermatic
    vein
    Secondary
    Tumor of the left kidney
    Retro-peritoneal masses
    Trauma

    GRADING
    GRADE 0

    Venous noise on doppler


    with Valsalva maneuver

    GRADE 1

    Distended veins can be


    palpated with Valsalva

    GRADE 2

    Distended veins can be


    palpated without Valsalva

    GRADE 3

    Distended veins can be


    observed

    INFERTILITY THEORIES
    Stases of blood with testicular hypoxia
    Reflux of renal and adrenal metabolites
    Increased intra-testicular temperature

    INDICATIONS FOR FURTHER


    MANAGEMENT
    Symptomatic
    * Pain
    * Mass (discomfort)
    Infertility
    Testicular atrophy

    TREATMENT
    Spermatic venography plus embolisation
    with heated contrast/resin/coils
    Surgery
    Open
    Ivanissevitch
    Paloma
    Laparoscopic

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