Dropsy of the testicles in newborns
Hydrocele, or dropsy of the testicles in newborns, externally manifests itself as a swelling in the groin area or an enlarged scrotum. This is due to the accumulation of serous fluid in the testicular membranes.
There are two types of dropsy:
- Isolated - the liquid is in one cavity and does not flow into another;
- Communicating - the fluid has the ability to flow into the abdominal cavity through the vaginal process of the peritoneum.
Hydrocele in newborns often forms simultaneously with an inguinal hernia, which makes it a very dangerous pathology. The additional membrane around the testicles interferes with proper heat exchange, which causes overheating. In turn, an increase in temperature leads to disruption of the hormonal functions of the testicles and incorrect spermatogenesis. The testicles are very sensitive to any fluctuations in the temperature environment, therefore, such changes in functioning in the future lead to infertility.
Causes of dropsy of the testicles in newborns
Communicating dropsy of the testicles in newborns is a pathology in which the non-overgrown vaginal process of the peritoneum, located between the cavities - the abdominal and surrounding testicles, allows fluid to enter the scrotum and back.
When the baby is still in the womb, the testicles of the fetus, through the inguinal duct, descend into the scrotum together with the vaginal process, which forms the membranes close to them. Normally, this process is overgrown after birth for several months, and the connection between the testicular membrane and the cavity disappears. The reason for the formation of a communicating dropsy is the non-union of the vaginal process, which serves as a channel for the movement of fluid from the peritoneum into the testicular cavity.
There is a theory that when the open processus vaginalis contains smooth muscle fibers that are normally absent in the peritoneum, they do not allow the process to grow together normally. Most cases of hydrocele formation are observed in children born before the term or as a result of pregnancy, proceeding under the threat of miscarriage.
There is another factor that causes communicating dropsy of the testicles in newborns - increased intrauterine pressure, which the fetus can experience in case of hyperactivity, excessive excitability, or during resuscitation during childbirth.
Isolated dropsy
This type of dropsy in infants occurs much more often communicating and disappears without intervention, usually no earlier than six and no later than twelve months. Such a pathology is directly related to trauma during childbirth, the specificity of the hormonal background and the incorrect removal of lymph from the scrotum in children under one year old.
In an isolated form, the hydrocele often increases, while with the accumulation of fluid, its pressure on the testicle membrane increases, and dropsy becomes tense. In this case, the child is punctured and the fluid is pumped out. No other surgical treatment is usually prescribed.
Treatment of dropsy of the testicles in newborns
To choose the correct method of treating dropsy of the testicles in newborns, the boy should be shown to a urologist, who, if necessary, will prescribe a number of diagnostic procedures:
- Transillumination (diaphanoscopy) - transillumination of the baby's scrotum with a light source;
- Ultrasound - examination of the structure of the organs of the scrotum using ultrasound;
- Laboratory tests (blood and urine tests) - to confirm the absence of side pathologies of the genitourinary system.
When the diagnosis is made - hydrocele, the doctor recommends treatment depending on the condition of the baby and his age.
Conservative practice implies regular monitoring of the child by a urologist until the age of two. Then you should observe it continuously for 2-3 months to identify the nature of the dynamics of the disease. If the prognosis is disappointing, surgery will be prescribed.
According to Dr. Komarovsky about dropsy of the testicles in newborns, this pathology occurs in most boys. And 99% of them spontaneously disappear, to a maximum of 2 years of age. He believes that it is worth sounding the alarm about this problem only when it causes a lot of trouble for the baby, in other cases you just need to wait.
To date, the following operations are performed to remove a hydrocele:
- Ross - practiced with a communicating form. The inner groin ring is excised and tied;
- Bergman - done in case of isolated dropsy. The inner shell of the testicles is excised as close to the base as possible, sutures are applied to its remnants, then a pressure bandage is applied to them for the entire rehabilitation period, if necessary, drainage is installed;
- Winckelmann - a kind of Bergman's method, now practically not used;
- Lord - the least traumatic, since the vaginal membrane is not excised, but corrugated directly in the body.
Surgery is prescribed for dropsy of the testicles in newborns and under the age of 2 years only in the presence of:
- Concomitant inguinal hernia;
- Significant periodic changes in the size of the scrotum (increase-decrease);
- Background infectious inflammation;
- Pain and discomfort in the groin area.
The risk of complications and relapses as a result of operations is no more than 8%.
But if you adhere to the norms of the postoperative period - regularly and carefully treat the baby's genitals, keep him from physical overstrain, follow the rules of hygiene, then negative consequences can be avoided.
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