Laparoscopy Assisted Open Repair of Bilateral Abdominoscrotal Hydrocele in 8 Months Old Baby—Rare Case Report

Bilateral Abdominoscrotal Hydrocele (ASH) is very rare in children and difficult to suspect on clinical examination. Abdominoscrotal hydrocele (ASH) is very unusual presentation of scrotal hydrocele with dumbbell-shaped extension intra abdominally through deep inguinal ring either communicating to peritoneal cavity or non-communicating. No theory can explain exact development of ASH though many theories have been proposed in literature. An abdominoscrotal hydrocele is a congenital pathology involving a scrotal hydrocele expanding through the inguinal canal and reaching the abdominal cavity (pars abdominalis). A simple hydrocele is commonly diagnosed clinically, where as an abdominoscrotal hydrocele is rare and should be differentiated from other cystic lesions of the abdominal cavity in children.

Infected Vaginal Hydrocele Due to a Septic Puncture-Aspiration: A Series of Seven Cases Collected at Yalgado Ouedraogo Teaching Hospital of Ouagadougou

Objective: To describe diagnostic and therapeutic outcomes of infected vaginal hydrocele.Material and Methods: This is a retrospective descriptive study over a period of two years from June 2013 to May 2015 at the urological emergency department of Yalgado Ouédraogo University Hospital (CHU-YO). Results: We collected seven cases during the period of study. The average age of patients was 35 years. Two patients (2/7) were from urban and five from rural areas. Five patients (5/7) were married and two (2/7) unmarried. Six patients (6/7) were farmers and one (1/7) was civil servent. Clinical examination findings were dominated by bilateral painful scrotal swelling and fever in all cases, a scrotal necrosis in two cases. The dominant indication of the puncture-aspiration was discomfort during sexual intercourse (5/7). At the opening of the scrotum purulent fluid was aspirated in all cases, and we performed a unilateral orchidectomy in two cases. A hydrocelectomy was performed in all cases. The postoperative evolution was simple in all patients. Conclusion: The puncture-aspiration must be avoided because the risk of infection and the high recurrence rate.

Individualized minimally invasive treatment for adult testicular hydrocele: A pilot study

BACKGROUND Hydrocelectomy is the gold standard for the treatment of hydrocele,but it often causes complications after surgery,including hematoma,infection,persistent swelling,hydrocele recurrence,and chronic pain. In recent years,several methods for minimally invasive treatment of hydrocele have been introduced,but they all have limitations. Herein,we introduce a new method of individualized minimally invasive treatment for hydrocele.AIM To present a new method for the treatment of adult testicular hydrocele.METHODS Fifty-two adult patients with idiopathic testicular hydrocele were included. The key point of this procedure was that the scope of the resection of the sheath of the tunica vaginalis was determined according to the maximum diameter(d) of the effusion measured by ultrasound and the maximum diameter of the portion of the sheath pulled out of the scrotum was approximately πd/2. The surgical procedure consisted of a 2-cm incision in the anterior wall of the scrotum,drainage of the effusion,and dissection of part of the sheath of the tunica vaginalis. After the sheath was peeled away to the predetermined target extent,the pulled-out sheath was removed. The intraoperative findings and postoperative complications were analyzed.RESULTS All patients were successfully treated with a median operation time of 18 min.The median maximum diameter of the effusion on ultrasound was 3.5 cm,and the median maximum diameter of the resected sheath was 5.5 cm. Complications occurred in four(7.7%) patients: two(3.8%) cases of mild scrotal edema,one(1.9%) case of scrotal hematoma,and one(1.9%) case of wound infection. All of the complications were grade I-II. Recurrent hydrocele,chronic scrotal pain,and testicular atrophy were not observed during a median follow-up of 12 mo.CONCLUSION We report a new technique for individualized treatment of testicular hydrocele,which is quantitative and minimally invasive and yields good outcomes. Further study is warranted to verify its potential value in clinical practice.

Effect of hydrocele on appendix testis in children

The purpose of this study was to investigate the effects of an elevated hydrostatic pressure of hydrocele on the structural integrity and steroid receptor expression pattern of the appendix testis in children. Twenty-six testicular appendages were obtained from boys （aged between 13 and 79 months, mean 40 months） who underwent surgical exploration because of hydrocele or congenital inguinal hernia. The tissue sections of testicular appendages were stained with hematoxylin-eosin. Immunohistochemistry and immunofluorescence laser microscopy were performed using monoclonal mouse anti-human receptors against androgen and estrogen receptors. Patients were divided into three groups： group A （n = 8） represented patients with groin hernia without hydrocele, who served as control group; group B （n = 7） represented patients with communicating hydrocele; and group C （n = 11） represented patients with noncommunicating hydrocele. The tissue sections of appendix testis expressed both androgen and estrogen receptors in all patients in groups A and B, and epithelial destruction was not present. The presence of androgen receptor （two of 11, P 〈 0.001） and estrogen receptor （four of 11, P = 0.006） was lower and the number of appendix testes with epithelial destruction was higher （eight of 11, P-- 0.001） in group C. We demonstrated that groin hernia and communicating hydrocele did not influence the receptor expression pattern and the anatomic structure of testicular appendages, whereas noncommunicating hydrocele caused damage as indicated by the absence of steroid receptors and destruction of the epithelial surface. A better understanding of the physiological role of testicular appendages may change the indications of surgical treatment in patients with noncommunicating hydrocele.

Pleomorphic rhabdomyosarcoma of the spermatic cord and a secondary hydrocele testis:A case report

BACKGROUND Pleomorphic rhabdomyosarcoma(RMS)of the spermatic cord is a group of rare neoplasms,and a secondary hydrocele testis occasionally occurs.The misdiagnosis of paratesticular mass may lead to a therapeutic delay.CASE SUMMARY A 79-year-old man presented to our clinic complaining of a 1-mo history of painless scrotal swelling.Physical examination revealed approximately a 15 cm×10 cm×5 cm inguinal mass with limited mobility.Contrast-enhanced magnetic resonance imaging showed a hydrocele testis,several enlarged inguinal lymph nodes,and a heterogeneously enhanced lesion with a relatively well-defined margin in the left inguinal region.Due to the imaging findings,he was diagnosed with pleomorphic RMS and received a wide resection of the mass,an inguinal incision with a high section of the left spermatic cord,and a left radical orchiectomy.He experienced local relapse 1 mo postoperatively and received radiotherapy and anlotinib hydrochloride-based immunotherapy as adjuvant therapy.The patient died 3 mo after the surgery.CONCLUSION The optimal interventions for advanced-stage pleomorphic RMS patients should be investigated by more preclinical studies and clinical trials.Physicians need to be aware of the occurrence of pleomorphic RMS in unusual locations,especially when accompanied by a hydrocele testis.

Surgical Management of a Giant Hydrocele of the Vagina in Adult

Introduction: Vaginal hydrocele is an amber-colored, sterile collection found between the parietal and visceral testis. It is said to be giant when it is larger than the patient’s skull or when it contains more than two liters of liquid. Objective: To report our method and the result of the surgical treatment. Observation: The authors reported an observation of a 50-year-old patient who consulted for a painless large left bursa. Clinical and paraclinical investigations, in particular scrotal ultrasound, have made it possible to diagnose a giant hydrocele of the vagina. The patient had surgical treatment which consisted of resecting of the vagina with hemostatic suture of the resected vaginal slice. The post-operation effects were not complicated. After a six-month setup, we did not notice any recurrence. Conclusion: Resection of the vagina with hemostatic suture of the resected vaginal slice in case of giant hydrocele could certainly give good results.

Epidemiological and Therapeutic Aspects of the Vaginal Hydroceles

Purpose: Our purpose was to describe the epidemiological and therapeutic aspects of the vaginal hydroceles. Methodology: It was a forward-looking and descriptive study of Mars 2014 in July, 2017, which realized in the service of general surgery of the Reference Health Center of Kati (Mali). All the patients operated in the service for hydrocele were included. Other causes of big stock exchange and hydroceles operated outside our service were not including. Results: We operated 92 hydroceles or 5.9% of the surgical activities of the service. The average age was of 34.5 years with extremes of 2 years and 82 years. The most frequent signs of hydrocele were the big painless stock exchange (100%);a transillumination positive (90%) and the effusion of the vaginal in the ultrasound (100%). The cure of hydrocele was realized according to the techniques of Bergmann (94.6%) and of Lord (5.4%). The mortality was nil and the morbidity was 3.3% (2 operating infections of the site and 1 bruise). Conclusion: The hydrocele is a frequent pathology in Africa. The therapeutic strategies are multiple and varied. However, we prefer the Bergmann technique, which is easy, fast and has few complications.

CD99and CD 106(VCAM-1)in human testis

Aim: The expression of the cytokines IL-2, IL-6, IL-10, IFN-γ and TNF-α and the adhesion proteins CD99 and CD106 was studied in the human testis at the protein level. Methods: The expression of the cytokines and the adhesion proteins was assessed using immunohistochemistry and immunoblotting. Results: None of the cytokines studied was present in the human testis, but CD99 and CD106 (VCAM-1) strongly were expressed in all the testes investigated. CD99 was present in the interstitial tissue of the human testis as well as in the Sertoli cells. The identity of the CD99+ interstitial cells is unclear. CD106 (VCAM-1) was present in Leydig cells as well as the basal parts of the Sertoli cells in the seminiferous tubules. In immunoblotting, CD99 was demonstrated at molecular ratios of 46-57 (kD). This is a novel isoform of the molecule. Conclusion: The human testis produces both CD99 and CD106 and as CD106 mediates cell binding to lymphocytes, it is possible that the human Leydig cells adhere to lymphocytes like the rodent Leydig cells. (Asian J Androl 2002 Dec; 4: 243-248)

Peritoneovaginal Duct and Nück’s Duct Persistence in Children at Campus Teaching Hospital in Lomé(Togo)

Introduction: Peritoneovaginal duct (PVD) and Nück duct (ND) include several abnormalities with many clinical entities that are at the cause of a variety of symptoms. These are frequent in pediatric surgeon practice and could lead to serious complications. The aim of our work was to describe the epidemiological, diagnostic and therapeutic aspects of pathologies of PVD or ND in our conditions after the first five years of surgical activities of our pediatric department. Material and Methods: This was a retrospective and descriptive study, carried out on the files of children, aged zero to 15 years, presenting PVD or ND pathology, operated in the service, over a period of 4 years (2016 to 2019). Results were classified good, medium or bad. Results: During the study period, among the 865 children operated in pediatric surgery, 164 children were found for PVD and ND pathologies (18.95%). The average age was 5.3 years old. There were 152 boys (92.68%) and 12 girls (7.32%). The reason for consultation was inguinal or inguino-scrotal swelling in 99.3% of the children. The right side was affected in 58.5% of cases. In boys, there were inguinal hernias (27.5%), inguinoscrotal hernias (30.3%), hydroceles (36.9%) and cysts (5.3%). In girls, there were inguinal hernias (91.7%) and 1 ovarian hernia (8.3%). The umbilical hernia was associated with these pathologies in 39 cases. Treatment was conventional closure of the PVD or ND. With an average follow-up of 2.5 years (range 3 months and 3.5 years), the results were good in all cases. Conclusion: Pathologies of PVD or ND took an important place in the activities of the pediatric surgery department. Management by conventional surgery has given good results in all cases. Early treatment of these pathologies helps prevent complications.