A painless mass that grows in one side of the scrotum

Introduction Diagnosis of hydrocele is not difficult. A painless mass that gradually enlarges in one side of the scrotum, which is smooth, cystic, and positive in light transmission, can be diagnosed. However, if accompanied by inflammation, bleeding, etc., the light transmission test can be negative.

Cause

The cause of a painless mass that gradually increases in one side of the scrotum:

(A) the cause of the disease: the cause of congenital hydrocele is caused by the incomplete closure of the sheath tube in different parts of the fetus before birth. The peritoneal fluid accumulates at a certain level through a closed abnormal sheath-like duct to form various types of hydrocele.

(B) pathogenesis: relevant research indicates that the effusion is secreted by the wall of the sheath and absorbed by the wall of the cavity. When the amount of secretion is greater than the amount of absorption, a hydrocele is produced. The wall of congenital hydrocele is thin, smooth and soft, and is clearly separated from the surrounding tissue. It is oval and translucent. According to relevant research, it is found that almost all of the pediatric hydrocele is connected to the abdominal cavity. The diameter of the sheath tube is generally about 2 mm, which is 5 mm thicker. In the longer course of the disease, the wall of the sheath wall is obviously thickened, but the thickness of the wall is uniform, and there may be multiple pseudonodular changes of small nodules, and even calcification may occur, and adhesion to adjacent tissues may occur. If the sheath tube can accommodate the intestine, the inguinal hernia is formed. The effusion is generally a yellow, clear, odorless exudate. The liquid contains electrolytes, fibrinogen, cholesterol, monocytes, and lymphocytes. The specific gravity is 1.010 to 1.025, and the albumin content is 3 to 6 g/dl. The amount of hydrocele is less than 10 ml, and can be as much as 300 ml or more. If the amount of fluid is large, the course of disease is long, the testicles and spermatic cord can be oppressed, affecting the blood circulation of the testis, accompanied by changes in interstitial edema and seminiferous tubules, which can eventually lead to testicular atrophy. According to the site where the sheath is closed abnormally, the hydrocele is classified into the following three categories.

1. spermatic hydrocele: occlusion of both ends of the sheath, the middle segment of the spermatic cord is limited by effusion, generally not communicating with the abdominal cavity, but often the cochlear process at the head side is not occluded.

2. Testicular hydrocele: Under normal circumstances, there is only a small amount of serum in the testicular sheath capsule. If the accumulation of liquid increases, the testicular hydrocele is formed.

3. Trafficous hydrocele: The sheath is not occluded, completely open, and the peritoneal fluid flows with the body position. The difference from the inguinal hernia is that the passage between the sheath capsule and the abdominal cavity is narrow, and the intestinal fistula cannot enter. When the girl has a cystic duct that is incompletely closed, it is called a round ligament cyst, which is a Nuck cyst.

an examination

Related inspection

Scrotal imaging laparoscopic

Examination and diagnosis of a painless mass that gradually enlarges in one side of the scrotum:

It is characterized by a groin or scrotal mass on one or both sides. When there is less fluid, there is no discomfort. As the fluid in the capsule increases, the spermatic cord may be felt or dull. For example, the amount of testicular hydrocele is huge, and the penis is retracted into the foreskin, which may cause difficulty in urinating and inconvenient walking. In children with traffic hydrocele, the mass disappears completely after lying down, and the mass gradually appears after standing.

The diagnosis of this disease is not difficult. A painless mass that gradually enlarges in one side of the scrotum, which is smooth, cystic, and positive in light transmission, can be diagnosed. However, if accompanied by inflammation, bleeding, etc., the light transmission test can be negative.

All kinds of hydrocele were positive (transparent) when tested for light transmission. There is a testicular hydrocele due to the long time, the wall of the sheath is extremely thick. The light transmission test can be negative (opaque). The hydrocele can not be diagnosed affirmatively. As long as the time is long, the wall of the sheath is extremely thick. The light transmission test can be negative (opaque). The diagnosis of hydrocele can not be confirmed, as long as the possibility of sputum can be ruled out, experimental puncture can be performed. The liquid drawn from the hydrocele is a pale yellow transparent liquid.

Differential diagnosis

Symptoms of a painless mass that gradually enlarges in one side of the scrotum:

Scrotal swelling: refers to the scrotal skin and its contents (the sheath testis, epididymis and spermatic cord) have lesions, or the contents of the abdominal cavity (ascites viscera) fall into the human scrotum, resulting in an increase in the size of the scrotum.

Painless scrotal mass: In the courtyard of the scrotum, usually only members of the testis, epididymis, and spermatic cord are inhabited, but sometimes strange faces appear, one of which is seminal vesiculitis. It is more common in middle-aged people. Seminal vesiculitis is a cystic, painless or mild pain, sometimes accompanied by a scrotal mass with a sense of falling, containing sperm and fluid.

Scrotal scrotal pain: orchitis, epididymitis is one of the common causes of scrotal swelling. More than fever, epididymis, acute swelling of the testicles and acute exacerbation of pain, later turned into chronic, the pain will follow, and when it is light and heavy. Sometimes the patient can feel a painful little hard knot in the scrotum.

It is characterized by a groin or scrotal mass on one or both sides. When there is less fluid, there is no discomfort. As the fluid in the capsule increases, the spermatic cord may be felt or dull. For example, the amount of testicular hydrocele is huge, and the penis is retracted into the foreskin, which may cause difficulty in urinating and inconvenient walking. In children with traffic hydrocele, the mass disappears completely after lying down, and the mass gradually appears after standing.

The diagnosis of this disease is not difficult. A painless mass that gradually enlarges in one side of the scrotum, which is smooth, cystic, and positive in light transmission, can be diagnosed. However, if accompanied by inflammation, bleeding, etc., the light transmission test can be negative.

All kinds of hydrocele were positive (transparent) when tested for light transmission. There is a testicular hydrocele due to the long time, the wall of the sheath is extremely thick. The light transmission test can be negative (opaque). The hydrocele can not be diagnosed affirmatively. As long as the time is long, the wall of the sheath is extremely thick. The light transmission test can be negative (opaque). The diagnosis of hydrocele can not be confirmed, as long as the possibility of sputum can be ruled out, experimental puncture can be performed. The liquid drawn from the hydrocele is a pale yellow transparent liquid.

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