Scrotal swelling may cause discomfort in children. The child may have pain or heaviness due to scrotal swelling. Scrotal swelling may be chronic or acute. Acute painful swelling requires immediate medical intervention.
Testicles are present in the scrotal sac. Scrotal swelling is the abnormal enlargement or swelling of the scrotal sac. Various conditions result in swelling of the scrotum. The condition may be acute or develop slowly over a period of time.
The children may or may not experience pain due to scrotal swelling. Acute pain due to scrotal swelling is a medical emergency condition and requires immediate attention. In some cases, the absence of sufficient treatment may result in testicle damage. In rare cases, the scrotal swelling may indicate the presence of cancer. Thus, it is important to consult with a pediatric urologist/surgeon if your child has scrotal swelling.
Following are some of the common causes of scrotal swelling:
Hydrocoele: Hydrocoele is the condition in which there is an accumulation of fluid around the testicle. This results in swelling of the scrotal sac. In normal development, the testicles descend into the scrotal sac through a tunnel under hormonal influences in the third month of pregnancy. This tunnel closes just after the child is born. However, in some cases, the opening fails to close, leading to the accumulation of fluid. Almost 10% of male children suffer from hydrocele at birth.
Inguinal Hernia: If the opening of the tunnel is small, it may result in hydrocele. However, if the tunnel opening is larger, the intestine may come out through this opening. This results in inguinal hernia. Premature babies are at increased risk of developing a hernia as compared to full-term babies.
Other conditions: Various other conditions that result in scrotal swelling are injury, tumors, and varicocele.
Diagnosis of scrotal swelling is through clinical examination:
Medical history: The doctor will ask you about your child’s medical history regarding the onset and associated symptoms or any injury in the scrotal region. The doctor may also ask the child if he is experiencing any pain in the scrotal region.
Physical examination: The doctor will perform the physical examination of the abdomen, scrotum, and testicles.
Diagnosis for hydrocele: For determining the presence of hydrocele, the doctor shines torchlight through the scrotum. The transillumination of light confirms the accumulation of fluid.
Diagnosis for hernia: The doctor will try to push back the lump into the tummy. If the lump goes into the abdominal cavity, it is an inguinal hernia.
Imaging techniques: In some cases, the doctor may also recommend an ultrasound
The treatment depends upon the cause of scrotal swelling.
Hydrocele: Hydrocele can be safely observed till 1.5 years of age during which it can resolve. Persistent hydrocele or hydrocele which are communicating require surgery.
Hernia: . Hernia condition should be operated as soon as it is diagnosed because of high risk of getting complicated as a result of strangulation.
Varicocele: Varicocele causes swelling in the blood vessels, which results in scrotal swelling. Treatment of varicocele can be through the surgical repair of vessels.
Tumors: The doctor may advise chemotherapy, radiation therapy, or surgery, depending upon the size and stage of the tumor.
The surgical procedure depends upon the cause of scrotal swelling. The doctor performs the surgery under general anesthesia. The surgery for hydrocele and hernia is same and is called as herniotomy. This can be performed by open or laparoscopic technique on day care basis.
The child after surgery is shifted in the recovery ward. The child recovers from anesthesia and surgery. Once your child feels comfortable, and all the vital parameters are stable, you may take your child home. The doctor may advise your child to wear diaper and loose clothes to keep him more comfortable.
Category : Scrotal Swelling
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