Water in the Scrotum. Hydrocele.
As the name shows, this is a collection of water in the scrotum or bag which holds the testicles.
Symptoms. It presents a swelling, shaped like a pear, smoothon its surface, fluctuating if pressed, without pain, but causing a little uneasiness by its weight. On placing a lighted candle on one side of the scrotum, the light may be seen through it.
Distinction. This complaint may be distinguished from a solid enlargement of the testicle by its not being so heavy, solid, or painful, and by its fluctuating and being transparent; from rupture, by its forming slowly instead of suddenly, by the swelling beginning at the lower part of the scrotum instead of the upper, and by the enlargement not being increased by coughing as it is in rupture.
Treatment. In children, strong scattering washes (353) are sometimes successful. But most commonly a number of punctures are made with a large needle, to cause the fluid to escape into the cell tissue of the scrotum, whence it is removed by absorption.
To effect a radical cure in grown persons, the surgeon is to grasp the tumor behind, and introduce a trocar and canula into the sac, being careful to point the instrument upwards, so as not to wound the testicle. The trocar is then withdrawn, the canula being at the same time pushed well into the sac, so that none of the fluid may get into the cell tissue outside the sac. The fluid runs of~ through the canula. When this has all escaped, some stimulating fluid, as common lime water, or, still better, tincture of iodine, is to be injected through the canula into the emptied sac. After retaining this from two to five minutes, it is permitted to flow out. Inflammation follows, which breaks up the secretion of water, and effects a cure in two or three weeks. The amount of fluid thrown in should be about one or two teaspoonfuls of a mixture of one part of tincture of iodine and two parts of water. If the first operation does not effect a complete cure, it may be repeated. The most successful of all treatments, however, is to open the scrotum and dissect out the greater part of the tissue which covers the testicle and which secretes the fluid.
A suspensory bandage which, by relieving the weight from the spermatic cord will cause great relief, is desirable and in early cases may prevent the troubles becoming serious enough to warrant operation.
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