A cystic, transilluminant, painless scrotal swelling presented with testes separately palpable. The procedure to be done is
Correct Answer: Lords' procedure
Description: (A) Lords' procedure # Hydrocele is a collection of serous fluid that results from a defect or irritation in the tunica vaginalis of the scrotum. Hydroceles also may arise in the spermatic cord or the canal of Nuck.> Structurally, hydroceles are classified into 3 principal types.> In a communicating (congenital) hydrocele, a patent processus vaginalis permits flow of peritoneal fluid into the scrotum. Indirect inguinal hernias are associated with this type of hydrocele.> In a noncommunicating hydrocele, a patent processus vaginalis is present, but no communication with the peritoneal cavity occurs.> In a hydrocele of the cord, the closure of the tunica vaginalis is defective. The distal end of the processus vaginalis closes correctly, but the mid portion of the processus remains patent. The proximal end may be open or closed in this type of hydrocele.> Hydroceles are located superior and anterior to the testis, in contrast to spermatoceles, which lie superior and posterior to the testis.> Hydrocele is bilateral in 7-10% of cases.> Hydrocele often is associated with hernia, especially on the right side of the body.> The size and the palpable consistency of hydroceles can vary with position. Hydrocele usually becomes smaller and softer after lying down it usually becomes larger and tenser after prolonged standing.> Systemic signs of toxicity are absent. The patient is usually afebrile with normal vital signs.> Abdominal or testicular tenderness are absent; no abdominal distension is present.> Bowel sounds cannot be auscultated in the scrotum unless an associated hernia is present.> Unless an infection causes an acute hydrocele, no erythema or scrotal discoloration is observed.> Transillumination A light source shines brightly through a hydrocele. Transillumination is common, but it is not diagnostic for hydrocele. Transillumination may be observed with other etiologies of scrotal swelling (eg, hernia).> The hallmark of treatment is eversion of the tunica through a surgical procedure called 'Lord's procedure' or an alternative 'Jsboulay's procedure'
Category:
Surgery
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