Features of bilateral surgery
Both sides are operated on in one anesthesia through separate incisions or one midline approach along the suture of the scrotum; the method of plastic surgery of the membranes for each testicle is selected individually - for example, Bergman for a large dropsy on the left and Lord for a small dropsy on the right. Scrotal swelling after bilateral surgery is more pronounced and lasts longer, so the jockstrap is worn for 2–3 weeks, and they return to work after 7–10 days. Before surgery, an ultrasound of both testicles with Doppler is required to exclude a tumor and assess the cause of bilateral hydrops.
When is surgery needed?
- hydrocele in an adult that persists for more than 6 months (in boys under 1–2 years of age, hydrocele often goes away on its own);
- enlargement of the scrotum, heaviness, discomfort when walking and sexual activity;
- rapid growth of dropsy, tense scrotum, pain;
- dropsy interfering with examination of the testicle and ultrasound control;
- relapse after puncture or sclerotherapy.
Before the operation, an ultrasound of the scrotum is required: under the dropsy there may be a testicular tumor, epididymitis or inguinal hernia that requires other treatment.
Hydrocelectomy methods
Bergman's operation - excision of excess membranes; used for large and long-term dropsy with thickened membranes. Winkelmann operation - the membranes are cut, turned inside out and sutured behind the testicle so that the fluid is absorbed by the surrounding tissues; Suitable for medium sized dropsy. Lord's operation - the membranes are not excised, but crimped with sutures around the testicle; is the least traumatic and is suitable for small dropsy with thin membranes. All options are performed through a single 3–5 cm incision in the scrotum under spinal or intravenous anesthesia and take 30–50 minutes.
Preparation and course of the operation
Examination: examination by a urologist, ultrasound of the scrotum with Doppler, general and biochemical blood tests, coagulogram, general urine test, tests for HIV, hepatitis, syphilis, ECG and consultation with an anesthesiologist. The day before - a light dinner, in the morning do not eat or drink for 6-8 hours, shave the hair on the scrotum.
In the operating room, after anesthesia, the surgeon makes an incision, removes the testicle with the membranes, evacuates the fluid and performs the selected option of membrane repair. The bleeding is carefully stopped, the wound is sutured with self-absorbing threads; Sometimes a thin drainage is installed for a day. The patient spends a day in the hospital.
Recovery
In the first days, the scrotum is swollen and painful - painkillers, cold and support underwear (suspensor) are prescribed for 2 weeks. Dressings are performed every other day. You can return to work after 5-7 days, to sports and heavy lifting - after 3-4 weeks, to sexual activity - after 2-3 weeks. The swelling completely subsides in 2–4 weeks, the final appearance of the scrotum is formed in 1–2 months. Relapse after surgery is less than 3%.
Treatment of hydrocele in Tashkent
In the clinics below, hydrocelectomy is performed by urologists and urologists-andrologists in a hospital setting with on-site ultrasound diagnostics, including for bilateral hydrocele. Prices are indicated according to the official price list of the clinic; Anesthesia and preoperative tests are paid separately. Sign up for a consultation - the doctor will confirm the diagnosis using ultrasound and choose the surgical method.
