In this article, a children's urologist gives answers to the most frequently asked questions about the watering of eggs (hydrocel) in children.
Content
- What is the difference in the yachka yarbachka, molding shells of eggs and hydrocel?
- These are different names of one disease. Eggwanking, otherwise, the hydrotole or molding of the egg shells is the accumulation of fluid in egg shells, which leads to an increase in the scrotum and, sometimes swelling in the groin area. Isolated molding of egg shells when the liquid surrounds the testicle and cannot flow into other cavities, and I inform me of a yachka shells, characterized by the fact that the water fluid can flow into the abdominal cavity and back through a special duct - vaginal peritoneum proceedings. Washerka Eggs often combined with groin hernia.
- What is the difference between the hydrothele (eggs of eggs) of newborns?
- In newborns and breast-age children, the yachka is in most cases isolated from the abdominal cavity and passes independently for 6-12 months (in 80% of observations). Watering eggs of newborns and infants associated with generic injury, features of hormonal status and the state of outflow of lymphs from the scrotum.
Isolated ovatanka eggs in children of the first year of life more often than two-way. Often there is an increase in the water, and it becomes tense. With stressed water, puncture (needle introduction) is usually held to remove fluid from the membranes of the testicles. Operations are rarely performed.
Treat or not treated
- Why water must be treated?
- The testicle is extremely sensitive to temperature changes and can only work normally in a narrow temperature range. Increasing the temperature of the egg even on the tenths of the degree violates the development and function of the egg. Wateranka is an additional shell around the egg, which prevents the recovery of heat and leads to overheating. As a result, spermatogenesis and the hormonal function of the egg is disturbed, which is the cause of infertility.
- How the reporting molding shells is formed?
- In the process of fetal development, the testicle falls into the scrotum through the groin canal. Together with him in the scrotum, the aburiety will grow up, forming an inner membrane of eggs. This is the so-called vaginal abnurbation process.
Normally, at the time of birth or during the first months of life, the upper part of the peritoneum process, passing through the groin canal and turns into a subtle litigation, and the message shell membrane with the abdominal cavity disappears. Thus, neither the peritoneal liquid nor the abdominal organs can penetrate the cavity where the testicle is. The lower part of the vaginal abnurbation process forms a slital cavity around the egg, which, which, with water, serves as container for water fluid.
The main reason for the emergence of the reporting water of the membranes of the egg - the incoming of the vaginal abnormal process. Then the liquid can flow from the abdominal cavity in the shell of the egg and accumulate there.
- Is it possible to spontaneous cure of the reporting water of the Egg?
- An independent infection of the peritoneum process and self-dissection of the reporting water of the Eggs is often observed in the first months of life and very rarely - later than 1 year (no more than 5% of observations). Most children with a reported watering of eggs requires operational treatment, which is recommended to be held aged 1.5 - 2 years.
Failure to comply with these recommendations leads to underdevelopment of eggs and a decrease in chances to have children.
- How long can you observe and not treat the water of eggs?
- Milky shells of eggs in children 1 year of life requires the observation of children's urologist-Andrologist. In the case of the accumulation of fluid and the appearance of voltage in the shells of the eggs, puncture with removal of water fluid is carried out. Sometimes repeated puncture. The reporting water is usually observed up to 1.5-2 years.
- When operations are performed when the egg is water?
- Operations with a reporting water of eggs are usually carried out in children in 2 years of age. From 1 to 2 years of operations about the reporting water are performed if:
- It combines water and groin hernia;
- When the volume of the scrotum clearly changes when the position of the body changes;
- Wateranka increases, causing discomfort;
- Infection joins.
- What kind of anesthesia is better suited to the child?
- The best option of anesthesia during operations about the watering of eggs in childhood. Modern combined anesthesia using local anesthesia for long-term and mask anesthesia.
- What operations are carried out in the water of eggs in children?
- The type of operation depends on the age of the patient and the characteristics of the water. With the reporting water, as a rule, the Ross method is used - the selection of the elements of the seed rope from a small section in the groin area, excision and tissue of the peritoneal process from the inner groove ring, as well as the formation «window» in egg shells. Operation is a delicate, requiring good technique - neat and gentle preparation with the preservation of all the anatomical formations of the seed rope - the seed-eyed duct and the vessels of the eggs, as well as the inguinal nerve.
Sometimes laparoscopic operations are used in the water of the egg, however, the injury, risk of relapses and complications when using them above, and the duration of the anesthesia is more, so they do not find widespread.
With isolated variants of the water, operations on egg shells, such as Operations of Bergman and Winkelman, performed from the scrotum section.
About postoperative complications
- How does a child feel after surgery?
- After the operation, the child is in the clinic from several hours to 7 days (depending on the clinic). Operations during water is usually well transferred to children and do not significantly interfere with their movements. However, with sharp moves or constipation as a result of an increase in intra-abdominal pressure or direct influences, the formation of hematoma in the field of scrotum and groin. Therefore, it should be limited to the activity of children before healing the postoperative wound and comply with the diet.
Within 2 weeks after the operation do not dress underwear, squeezing the scrotum to avoid pushing the eggs up to the inguinal canal, due to the possible fixation of the egg over the scrotum. Children of school age are exempt from physical education for 1 month.
- What complications are occurring after operations about the water of the egg?
- The total risk of complications ranges from 2 to 8%. Especially the high percentage of recurrences is noted in untimely performing operations.
Water recurrences are encountered with a frequency of 0.5 to 6% . In adolescence, recurrences of water marks more often. The risk of infertility after such operations may be a consequence of a seeding duct operational injury and amounts to about 2-5%.
One of the complications is the high fixation of the egg, when the testicle in the process of operation pulls up to the inguinal channel and is subsequently fixed there by scar battles.
Egg atrophy occurs rarely and is associated with circulatory impairment in the egg arising from the mobilization of the peritoneal process from the elements of the seed rope.
Sometimes in the postoperative scar area there are unpleasant or painful sensations - hyperesthesia associated with infringement in the RubE or damage to nerve endings. These phenomena usually disappear in 6-12 months after surgery.
- How can I prevent the development of postoperative complications?
- Prevent the development of complications allow a high level of operations of operations and timely definition of indications for surgical treatment.
In compliance with the terms of surgical treatment and technically impeccable operations, the forecast for health and the ability to have children favorable in the overwhelming majority of observations.
