Hydrocele

　　Hydrocele can be classified into primary and secondary types. The primary cause is unclear, the course is slow, and it may be related to trauma and inflammation. Secondary cases have primary diseases, such as acute orchitis, epididymitis, spermatic cord inflammation, trauma, hernia repair, post-surgical scrotum, or secondary to systemic symptoms such as high fever, heart failure, ascites, etc., manifesting as acute hydrocele. Chronic hydrocele is seen in orchitis, syphilis, tuberculosis, and tumors. In tropical and southern China, hydrocele is usually caused by filariasis or schistosomiasis. Infantile hydrocele is related to the delayed development of the lymphatic system, and when the lymphatic system of the tunica vaginalis matures later, the effusion can be absorbed spontaneously.

　　Mild hydrocele may not affect fertility, but severe hydrocele can cause the penis to be hidden in the scrotal skin, affecting normal sexual life. In addition, due to the long-term compression of the testicles, poor local blood circulation can occur, leading to testicular dysfunction and affecting fertility. The impact of secondary hydrocele on fertility depends on the condition of the primary disease. If hydrocele is not treated in a timely manner, the problem can be very serious. Experts remind that many male infertility symptoms are also related to hydrocele. After being diagnosed with the disease, one should not delay treatment, otherwise the best treatment time may be missed, leading to more serious consequences.

　　The clinical manifestations of hydrocele are more common on one side, with a cystic mass in the scrotum, gradually increasing in a chronic painless manner. A small amount of fluid may be asymptomatic; when the amount of fluid gradually increases, the affected side of the scrotum may have a feeling of descent, traction, or distension. If the fluid is large, the penis may be retracted into the foreskin, affecting urination, sexual life, and walking. The physical examination of hydrocele varies with the type and shows different manifestations:

　　1, Testicular hydrocele

　　There is a lot of fluid in the tunica vaginalis of the testicle,呈卵圆形或球形, smooth in surface, with a cystic sensation, no tenderness, the testicle and epididymis are not palpable, and a positive light transmission test is performed.

　　2, Spermatic hydrocele

　　Cystic effusion is located above the testicle in the scrotum or in the inguinal canal,呈椭圆形或梭形, smooth in surface, moves with the spermatic cord, with a positive light transmission test, and the testicle and epididymis can be palpated below.

　　3, Mixed type hydrocele

　　Testicular and spermatic hydrocele coexist simultaneously, without communication, and can be complicated with inguinal hernia or undescended testicle.

　　4, Testicular spermatic hydrocele

　　The processus vaginalis is closed at the internal ring, but not at the spermatic cord, and is connected with the tunica vaginalis of the testicle, which is often pear-shaped, located in the scrotum, and the testicle and epididymis are not palpable. The external orifice is expanded due to compression, but it is not connected with the abdominal cavity.

　　5, Communicating hydrocele

　　The amount of fluid is related to body position, the amount of fluid decreases or disappears when lying flat, increases when standing, and can be felt on the testicle and epididymis, with a positive light transmission test. If the communication between the processus vaginalis and the abdominal cavity is large, the omentum or mesentery can enter the processus vaginalis and appear as an indirect inguinal hernia.

　　Hydrocele has a high incidence in tropical areas, which is related to filarial infection, so preventive measures against mosquitoes are important in daily life. In rural areas, due to various reasons, the treatment of hydrocele is not given enough attention, so it is often damaged by severe hydrocele, affecting the function of both testicles. Therefore, it is necessary to call for early medical treatment. Hydrocele in infants and young children is congenital. With age and growth, the function of the lymphatic system is healthy, and most can be absorbed spontaneously without urgent treatment, and can be observed dynamically and regularly reviewed.

　　Hydrocele is easy to diagnose and does not require special examination. However, if it is necessary to exclude testicular tumor or tuberculosis, corresponding transrectal, seminal vesicle, scrotum, and penis ultrasound examinations should be performed. But if the scrotal mass is solid, it is not advisable to perform puncture examination. Ultrasound examination can show the mass as a liquid shadow area. Hydrocele cavity can be punctured to extract fluid. Normally, it is a bright yellow clear liquid; if it is complicated with infection, it can be turbid hemorrhagic or purulent fluid; in patients with filariasis, it can be chyle-like fluid.

　　Hydrocele is one of the causes of male infertility, so men must pay attention to it and learn more about the knowledge of hydrocele. Once symptoms are detected, not only timely treatment but also attention to diet is required. In terms of diet for hydrocele, it is recommended to eat more high-protein, high-vitamin, easily digestible, and fibrous foods to enhance the body's resistance and prevent constipation. Maintain a pleasant mood, develop good living habits. Diet also has something to do with the effectiveness of disease treatment. Try to eat semi-liquid food as much as possible, easy-to-digest food, and reduce the burden on the gastrointestinal tract. However, nutrition must be comprehensive, and high-protein, high-vitamin, low-fat and low-salt diet, spicy and stimulating foods, rich and greasy foods, barbecue, preserved foods, etc., should be eaten as little as possible.

　　Self-esteem is very important for men. If a man becomes infertile, it not only injures their self-esteem but also makes them lose faith in life. Infertility also comes in many forms, and hydrocele is a common one. Men with hydrocele should actively seek treatment, but how to treat it well?

　　1. Symptomatic treatment

　　For those with little fluid and no obvious symptoms for a long time, and hydroceles in infants and children, and those caused by trauma, there is a possibility of spontaneous regression. Secondary hydroceles caused by acute inflammatory diseases and other systemic diseases are mainly treated for the primary disease to promote the regression of the effusion.

　　2. Injection therapy

　　After aspiration, inject刺激性药物 such as silicon oil, sodium laurel sulfate into the tunica vaginalis cavity to cause inflammatory adhesion. This method is to eliminate the tunica vaginalis cavity. This method has a large reaction, incomplete adhesion, and forms multicavitary hydroceles. This brings more difficulties to surgical treatment. Currently, it is used less.

　　3. Surgical treatment

　　Congenital hydrocele is mainly treated by surgery, the main purpose of which is to perform a high ligation of the hernial neck at the internal ring to block the downward flow of peritoneal fluid.

　　4. Simple puncture and fluid aspiration

　　Simple puncture and fluid aspiration is only a palliative therapy and cannot cure the disease. However, it can temporarily alleviate symptoms for those with excessive tension and pain, and can also be chosen for the elderly and weak who cannot withstand surgical treatment.

　　5. Fluid aspiration and drug injection therapy

　　There is no consensus on this treatment, some inject tetracycline, and some inject hormone drugs. Research has found that the use of tetracycline and other intravesicular injections can cause serious damage to the testicles.