Hydrocele

Subject: Child Health Nursing

Overview

A hydrocele is an abnormal fluid buildup between layers of the tunica vaginalis in the scrotum. The scrotum, the loose pouch of skin under the penis, swells because of a fluid-filled sac encircling a testicle. Most hydroceles dissolve without therapy within the first year of life and are common in babies.

Hydrocele

A hydrocele is an abnormal fluid buildup between layers of the tunica vaginalis in the scrotum. The scrotum, the loose pouch of skin under the penis, swells because of a fluid-filled sac encircling a testicle.

Most hydroceles dissolve without therapy within the first year of life and are common in babies.

Types

  • Communicating hydrocele
    • If the opening between the abdominal cavity and the scrotum has not closed properly and completely, abdominal fluid pass into the sac around the testis, causing a mass called a communicating hydrocele.
  • Non-communicating hydrocele
    • A hydrocele in which the upper segment of the processes vaginalis has been obliterated but the tunica vaginalis still contains peritoneal fluid is called non-communicating hydrocele. This js common in newborn and often subsides spontaneously as fluid is gradually absorbed.

Causes

  • Unknown
  • Premature baby and low birth weight infants.
  • Hydrocele in a newborn may mean there is an opening between the abdomen and the scrotum.
  • Scrotal injury
  • Inflammation or infection of the epididymis or testicles
  • Peritoneal dialysis

Sign and symptoms

  • Usually, the only indication of hydrocele is a painless swelling of one or both testicles.
  • Adult man with a hydrocele may experience discomfort from the heaviness of a swollen scrotum. Sometimes, the swollen testicles may be smaller in the morning and larger late in the day.

Diagnosis

  • History taking
  • Physical examination
  • USG

Treatment

  • Needle aspiration
  • If hydrocele gets larger or causes discomfort, surgery to remove the hydrocele (hydrocelectomy ) may be needed.
  • A surgical requirement is indicated if a spontaneous resolution does not take place by the age of 1 year of life.

Nursing management

If surgical procedure is required provide

  • Pre- operative care;
    • Proper explanation to parents and take informed consent.
    • Admit the baby the day of surgery and observed,
    • Check for standard preoperative test and investigation,
    • Discontinue medicine such as aspirin before surgery if taken by a patient,
    • Open intravenous line and maintain intake output,
    • Keep child nil per oral,
    • Psychological support to child and parents as well.
  • Post- operative care;
    • Keep the operative site clean and dry,
    • Check for any sigh of infection,
    • Manage pain by giving painkiller,
    • Change a diaper as soon as become damp,
    • Advice parents to give a child sponge bath and encourage parents to maintain hygiene of child

 

 
Things to remember

  • A hydrocele is an abnormal fluid collection in the scrotum between layers of the tunica vaginalis.

  • It is a fluid-filled sac surrounding a testicle that results in swelling of the scrotum, the loose bag of skin underneath the penis.

  • The exact cause is still unknown but the underlying cause of hydrocele are a premature baby and low birth weight infants, scrotal injury, and hydrocele in a newborn may mean there is an opening between the abdomen and the scrotum.
  • The types of hydrocele are communicating and non-communicating hydrocele.

  • Basically, a surgical requirement is indicated if a spontaneous resolution does not take place by the age of 1 year of life.

Videos for Hydrocele
hydrocele
Questions and Answers

A hydrocele is an abnormal fluid buildup between layers of the tunica vaginalis in the scrotum. The scrotum, the loose pouch of skin under the penis, swells because of a fluid-filled sac surrounding a testicle.

Types

  • Communicating hydrocele
    A mass known as a communicating hydrocele is created when abdominal fluid leaks into the sac that surrounds the testicles because the opening between the abdominal cavity and the scrotum has not closed properly and completely.
  • Non-communicating hydrocele
    Non-communicating hydrocele is a type of hydrocele in which the tunica vaginalis still contains peritoneal fluid despite the upper segment of the processes vaginalis being destroyed. This is typical in newborns and frequently goes away on its own as the fluid is gradually absorbed.

Causes

  • Not known
  • Newborns with low birth weight and preterm babies.
  • A newborn with a hydrocele might have a gap between the scrotum and the abdomen.
  • Scrotal damage
  • Epididymis inflammation or infection

Nursing Management

If surgical procedure is required provide

  • Pre- operative care ;
    • Admit the baby the day of operation and observe; provide parents with the right explanation and obtain their informed consent.
    • Verify the existence of the usual preoperative tests and investigations,
    • If the patient is taking medication before surgery, stop taking it, such as aspirin,
    • Maintain intake output while opening the intravenous line,
    • Keep the child from speaking, and offer both the child and the parents psychological support.
  • Post- operative care;
    • Keep the working area dry and clean,
    • Look for any infection signs,
    • Treat pain by administering a medication,
    • Replace a diaper as soon as it becomes wet,
    • Encourage parents to give their children sponge baths and to keep their children's hygiene up by giving them advice.

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