ATTENTION TO groin hernia and cord hydrocele
Maybe you know hernia, but you have just heard the definitions of hydrocele and cord hydrocele. However, these three different definitions are the names of different diseases caused by the same cause. Moreover, important diseases that prevent the healthy development of your baby and often lead to surgery.
The testicles of a male baby in the mother’s womb descend into the bag from the 28th week. In its normal course, the canal that descends after the testis descends should be closed. However, in some babies, this canal that has completed its function cannot be closed. this is the main reason.
THE DIFFERENCE BETWEEN groin hernia and hydrocele
After the testis descends into the bag, it does not close even though it should be closed, and the diameter of the continuing opening is important. Because this diameter determines the formation of hydrocele or inguinal hernia. How?
If the opening is wide enough to allow the entrance of any organ or organ part, an inguinal hernia occurs. If it is narrow enough to allow only fluid passage, it appears as a hydrocele.
Here is the reason why the testicles of babies with hydrocele appear large and swollen, because they are filled with fluid passing through this unclosable canal.
However, although it is not very common, there is another condition that experts call cord hydrocele (cord cyst).
CONTRARY TO WHAT IS ACTUALLY BELIEVED, HYDROCEL IS A VERY COMMON CONDITION. Experts state that clinically, about 60% of newborn boys have more or less fluid in the bag.
HOW CAN A HYDROCELE BE DETECTED?
The first finding that makes parents suspicious is swelling in the baby’s bag. It can be easily detected by examination by a doctor.
WHAT IS CORDS HYDROCELE?
Cord hydrocele is more difficult to diagnose, also known as (cord cyst), when it settles in the inguinal canal, it is very similar to inguinal hernia, especially strangulated inguinal hernia, and needs to be differentiated.
Cord hydrocele can be considered in the presence of swelling in the inguinal canal for a long time and the absence of vomiting, restlessness and inability to poop.
Especially when the testicle is retracted during examination, this mass moves in the same direction as well as helping the diagnosis. The point that parents should pay attention to is that they should definitely apply to a pediatric surgeon for diagnosis.
THERAPY OF HYDROCELE
Hydrocele seen in a newborn baby boy is highly likely to disappear spontaneously.
This period is the first six months, but the possibility of spontaneous disappearance is thought to last up to 1.5 years of age. That’s why the baby is followed until 18 months old, if the hydrocele has not passed, surgical intervention is planned.
THE PLACE OF LAPAROSCOPIC SURGERY IN CHILDREN’S HYDROCELE
Laparoscopic surgery, which has been up-to-date in recent years, has also been tried in the treatment of inguinal hernia and hydrocele in children. :
1- The openings used in laparoscopic surgeries are evaluated as potential hernias, and the need for closure is still a matter of debate
2- On the other hand, nowadays, laparoscopic surgery is repeated by 20% even in the best hands. there is a risk.
3-in addition, the possibility of damage to structures such as the uterus and testicular vessels is more than open surgery.
Open surgery is the standard method of inguinal hernias in children with its successful results, few complications and a small scar that can hardly be detected. Besides being a more expensive treatment method, laparoscopy surgery is still the standard method today as the scar left by the duration of the operation and the success of the treatment. has not been able to gain an advantage over the treatment (open surgery).
Inguinal Hernia
An existing canal between the abdomen and the bags should be closed during delivery. If this canal is not closed for some reason, inguinal hernia develops. intestinal segments are formed when they pass into this canal. The most feared situation in inguinal hernia is that these intestinal segments do not go back to the abdomen, that is, suffocation. The most important risk in strangulation of inguinal hernia is the deterioration of blood flow of the testis and the strangulated organ on that side. each face Inguinal hernia is seen in all four boys. In girls, the frequency of inguinal hernia is four times less than in boys. 60% of the patients have inguinal hernias on the right, 40% are on the left and 10% are on both sides. premature babies, The rate of inguinal hernia is much higher in babies born with low weight, especially in these babies, the risk of bilateral hernia is quite high.
WHAT ARE THE SYMPTOMS OF groin hernia?
The first symptom that attracts the attention of parents is swelling in the groin that appears and disappears
Swelling becomes more evident in situations that increase intra-abdominal pressure such as crying, coughing, and straining. He draws attention to the fact that the first symptom may be suffocation. The most important symptom in suffocation is restlessness, swelling and redness, vomiting, and inability to poop. The difference in girls is that in addition to the intestines, the ovaries also have hernia sacs.
HOW DIAGNOSED?
Parents’ description of a swelling in the inguinal region is sufficient for the diagnosis of hernia in children. Also, pediatric surgeons can diagnose with physical examination as well as the patient’s complaint. Ultrasonography used for diagnosis is an auxiliary diagnostic method, but pediatric surgeons do not need this method. can be diagnosed by physical examination.
THE POSSIBILITY OF AGAINST HERNIA AFTER HERNIA SURGERY PERFORMED BY SPECIALISTS IS VERY LESS TO NEVER.
There is a possibility of hernia development on the other side after the operation performed on one side.
HAZARDS OF groin hernia
The most common danger is hernia strangulation. Here, intestinal segments and the testicle on that side may rot. Therefore, as soon as a hernia is diagnosed, surgery should be planned.
There is a close relationship between the risk of drowning and age. The risk of drowning in the first year of life is higher than in other periods.
THE SURGERY IS VERY SIMPLE AND HORRIBLE
PARENTS DO NOT FEAR SURGICAL INTERVENTION.
It is also beneficial to have an operation in a few days for babies and children diagnosed with inguinal hernia. Because the risk of hernia strangulation is mostly in the newborn and infancy period.
Parents think that their babies are very small and are cold towards the idea of surgery.
However, one should not be afraid of the surgery performed by specialists in a suitable environment.
In many pediatric surgery centers in our country, hernia and hydrocele operations are performed within the framework of daily programs. Children are discharged to their homes 2-3 hours after the operation to return to their daily activities. After the operation, it is necessary to pay attention to the cleaning of the operation area. Wounds Since it is aesthetically stitched, there are no scars and there is no need for stitches to be removed. Slight swelling and bruises can be seen on the bags for a few days after the surgery. These disappear within a few weeks. The child can take a bath on the 5th day after the surgery.
Op.Dr.Emir Imani
Pediatric surgeon
