Hydrocoele - Conservative or surgical?

Case continued, check attached case below So this is a case of Hydrocoele, when I did transillumination test, it came out to be positive Urine R,M and CBC is WNL He compalints of mild pain while urinating, and admits left scrotum decrease in size and increase to the size as shown, not more than shown size Right testicular pain is resolved now I have ruled out testicular torsion, epididymitis, varicocoele. So give me your opinion regarding managing this case of hydrocoele? Do we need a conservative one or a surgical approach for this? Also tell me about scrotal support, which would be best?



It is a case of hydrocele- considering the positive transillumination test is positive. Another diagnosing clinical finding which differentiates hydrocele from hernia is that in hydrocele you can get above the swelling and cough impulse is absent. Most likely it is a case of Primary hydrocele. Rule out secondary hydrocele which could be due to . 1 Filariasis 2.Tuberculosis . 3.chronic epididymo- orchitis . 4.Malignancy . 5.Torsion Get an ultrasound of the scrotum and testis including colour doppler .. On ultrasound if it is a small hydrocele- wait and watch . If no secondary cause is found - and hydrocele is moderate in size as it appears - surgery with Jaboulay 's operation and Eversion of sac is indicated
Advise-usg scrotum to R/o malignancy and to confirm hydrocele of testis. Transllumination test -+ve. If fluid is minimum then conservative tt may be tried for 5days. If not responded then surgery done .scrotal support by thin linen cloth as a form of sannt mahatma langot for 7days. Size of testis decrease or increase not maters untill massive hydrocele exists.
Most hydroceles in India are either idiopathic or filarial. Since you have ruled out other causes and patient is symptomatic, give a trial of hetrazan.If he has completed the family and is not interested in more children, and is really bothered - the hydrocele is small-, then go for surgery.
Confirm with usg looks hydrocoele dd filiria due this infection milky white transudate so hydrocoele generaly not painful I will treat as filirial or gonococcal orchitis scrotal support to save injury otherwise chances of haematocoele
So far management of hydrocele is concerned it is always only SURGICAL Only conservative support in this case is SCROTAL SUPPORT No antibiotics or antiinflamatory can resolve the fluid collection LORD'S IS OPTION
What kind of scrotal support are available in market and can be given?

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In my opinion surgical procedure is best
Hydrocoele needs surgery only
Eversion of sac
Confirm hydro electric by doing scrotal usg Scrotal support is only conservative one Surgical approach suggested
Can you send ultrasound and color Doppler images. Conservately
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