EFFECT OF HYDROCELECTOMY ON TESTICULAR SIZE IN ADULT PATIENTS WITH UNILATERAL IDIOPATHIC HYDROCELE (HYDROCELECTOMY & TESTICULAR SIZE)

Abd Kadhim, Mohammed

	EFFECT OF HYDROCELECTOMY ON TESTICULAR SIZE IN ADULT PATIENTS WITH UNILATERAL IDIOPATHIC HYDROCELE (HYDROCELECTOMY & TESTICULAR SIZE)
IRAQI JOURNAL OF MEDICAL SCIENCES
Article 1, Volume 6, Issue 3, 2008, Pages 91-98
Author
Mohammed Abd Kadhim
Abstract
Background: The testes are paired organs that lie within the scrotal sac which is subdivided into two compartments by the scrotal septum,and supported by the tunica vaginalis, which is formed of 2 layers. In most normal subjects,small amount of fluid (1-2mL) can be seen within the leaves of the tunica vaginalis. Hydrocele is exist when an excessive amount of fluid is present. Hydrocele is divided into congenital & acquired. Virtually all hydroceles are congenital in neonates and infants, whereas most of the acquired causes of hydrocele are idiopathic. Other causes of acquired hydrocele include: infection, tumors, trauma, and torsion and trradiation therapy. Hydrocele is the most common cause of painless scrotal swelling. Objective: to determine whether there is an effect of hydrocelectomy on testicular size in adult patients with unilateral idiopathic hydrocele. Patients and Methods: This prospective study was done in the ultrasound unit of ALkadhimyia teaching hospital from the period of July 2006 to November 2007. Thirty three patients with a mean age of 35.8 years who had unilateral idiopathic hydrocele and who underwent unilateral hydrocelectomy were included in the study. The ultrasound examination was done in the supine position & included the preoperative evaluation of the hydrocele, & assessment of the testicular volume of the involved and uninvolved sides before and after surgery. Calculating the testicular volume from the formula: volume = length × width × depth × 0.52. Results: a statistically significant differences in the testicular volumes between the normal side (mean ± SD, 18.42± 2.02 mL) and the side with the hydrocele (23.23± 2.31 mL) before surgery (p < 0.001), and in the volumes in the side with the hydrocele before (23.23± 2.31 mL) and after (17.77± 2.22 mL) surgery (p <0.001). No such difference in volume was seen in the normal side before (18.42± 2.02 mL)and after (18.46± 2.05 mL) surgery (p =0.200). Also no significant difference in the testicular volumes of the normal side (18.46± 2.05 mL) and the side with hydrocele (17.77± 2.22 mL) after surgery (p = 0.150). The mean reduction in volume in the testis with the hydrocele after hydrocelectomy was 23.22%. Conclusions: There is an association between the development of an idiopathic hydrocele and testicular size. We believe that the increment in the volume is due to an increase in the impedance to venous and lymphatic flow. Surgeons should be aware that there is a decrease in testicular volume after hydrocelectomy so they do not misdiagnose this change as post-operative trauma or atrophy often in correlation with clinical symptoms, clinical examination & assessment.
Keywords
Hydrocelectomy; Testicular size; Idiopathic Hydrocele

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