All about testicular hydatid torsion. Acute lesions of hydatid

Testicular diseases are often associated with torsion hydatids around its axis.

This is the name of the rudiment, which is located in the upper part of the testicle.

When the hydatid rotates, the blood supply is disrupted and necrosis of the scrotal tissue begins.

To avoid severe consequences, it is important to start treatment for this disease on time.

After all, if left unattended, this problem can lead to death.

What it is?

The hydatid is a round formation consisting of connective tissue. It has a diameter of approximately 1 cm, and is also distinguished by a loose structure and thin vessels. The scientist Morgagnii was the first to describe the hydatids of the testicle and epididymis, so they began to be called after him.

This formation does not perform any function in the body, that is, it is a rudiment. It can twist or degenerate into a cyst later. As a result, the epididymis may rotate around the stalk.

Torsion of the testicular hydatid is known in 3 variants:

• extravaginal torsion occurs mainly in newborns. In this case, the testicle rotates around its axis simultaneously with its membranes;
• intravaginal torsion is observed inside the vagina or inside the testicular membrane;
• mixed torsion combines features of both options.

Brief medical history

The testicular hydatid is a rudiment and does not cause any problems until it twists around the stalk. This leads to scrotal trauma and necrosis. This disease often occurs in childhood, since their connective tissue contains a lot of liquid. In addition, the muscles of children are characterized by weak nervous regulation.

Prevalence and significance

This disease is widespread, and most often it occurs in children and young men.

The significance of the disease is associated with the serious consequences to which it can lead. Therefore, an examination by a doctor when the first signs of illness appear is of paramount importance.

Risk factors

This disease can lead to complications only if treatment is not carried out in a timely manner or if it is prescribed incorrectly. Most often, the so-called purulent melting of the hydatid occurs. As a result, pus appears in the scrotum, which may result in the removal of the testicle or scrotum itself.

There is also a danger possible infection blood, which manifests itself in high fever, sweating, fatigue, drowsiness and lethargy. It can all end with the patient falling into a toxic coma and his death.

Most often occur local complications which may result from an incorrectly performed operation. When dressing during surgical intervention vas deferens, a serious complication will be a violation of spermatogenesis and resulting infertility. Another negative consequence diseases - temporary or permanent erectile dysfunction.

Video: "Torsion of the hydatid (18+)"

Causes and consequences

The reasons that lead to torsion of the testicular hydatid may be the following:

• injury to the scrotum, which causes torsion of the hydatid and its necrosis. Symptoms of the disease are usually well expressed;
• frequent hypothermia;
• stress;
• cloth small size, that is, tight;
• pathology of intrauterine development.

Testicular hydatid torsion is a disease that is most often observed in infancy and childhood. It can be caused by various external factors, such as lifting weights or running. Sometimes a strong cough or physical activity leads to this problem. In some cases, medical intervention leads to the development of the disease.

Symptoms and diagnostic methods

Hydatid torsion is expressed in the following symptoms:

Torsion of the testicular hydatid occurs in 3 stages.

At the first stage of the disease clearly visible pain syndrome in the scrotum and its swelling, which appears along with redness.

In the second stage disease, a decrease in edema and a clearly defined hydatid in the form of an oblong formation can be observed. In this case, pressing with your fingers on it leads to severe pain. The doctor prescribes medication for this.

Without treatment, the third stage occurs, in which necrosis of the tissues of the hydatid and testicle occurs. Pus appears in the scrotum, as a result of which it has to be removed.

Naturally, at the first signs of the disease you should consult a doctor, as this will help avoid dangerous complications. Boys need to be treated carefully, as they tend to hide health problems, especially in adolescence.

Diagnosis of the disease can be carried out at an early stage. It consists of the following activities;

• examination of the child by a doctor;
• palpation of the painful area;
• taking a puncture;
• taking tests;
• Ultrasound. This method examination of the patient helps to find the location of the formation and its size. Ultrasound can also determine the best place for making an incision during surgery;
• Diaphanoscopy is a transillumination of the scrotum with a flashlight, as a result of which a bean-shaped darkening can be easily detected. It is the epididymis that has changed as a result of the disease.

Treatment

Surgery

Testicular hydatid torsion in boys is generally treated with surgery.

For this, general anesthesia is used. Surgical intervention avoids tissue necrosis and the appearance of pus in the scrotum. The operation involves making a skin incision and clamping the hydatid. Next, the formation is cut off with a scalpel and tied with thread.

In the postoperative period, antibiotics are prescribed, for example, Ampicillin. This is necessary to prevent further infection of the wound.

Used to treat wounds antiseptic drugs, for example, an alcohol solution of iodine. Also, after surgery, doctors often prescribe galvanization, UHF and magnetic therapy.

After surgery, the child must be protected from colds to avoid complications. You should also not swim in cool water and drink cold drinks.

Treatment at home

Since the main method of treating the disease is surgical, other means of treatment are practically not used. If you use compresses to treat a disease, you can only increase inflammation. This will cause the infection to spread to the scrotum area and the entire body. The development of sepsis can lead to death.

To heal the wound after surgery, the following means are used:

• oil with burdock root, which is used to lubricate damaged areas;
• a decoction of burdock root, which is drunk 3 times a day before meals;
• You can also use an infusion of eucalyptus leaves with the addition of honey. This composition is used to lubricate wounds;
• mixture of Sophora fruits and goose fat is also good remedy for lubricating wounds. The ointment should be stored in the refrigerator. You need to apply this product to the seam 2 times a day.

Diet

Diet plays no role in treatment or prevention of this disease, since it is associated with external factors or pathology of intrauterine development.

Prevention

Prevention of the disease is often impossible, since not all patients are aware of its existence.

It can only be detected at an appointment with a urologist, but even this doctor may confuse hydatid torsion with epididymal epididymis due to insufficient experience or inattention.

But it is worthwhile to engage in disease prevention, as this will avoid serious problems with health.

Injuries to the scrotum often lead to this condition and should be avoided. It is also undesirable to cool the testicles too much and not to swim in too cold water.

Forecast

Most often, the prognosis for this disease is quite favorable. But in the absence timely treatment, and also when improper treatment Sepsis may develop, which leads to the death of the patient. In complex and advanced cases, removal of the testicle is required.

In terms of performance, this disease is also assessed as favorable, since it has practically no effect on it.

Conclusion

Hydatida is a round formation that may appear in the testicles or epididymis. This rudiment does not play any role in the body, but if twisted it can cause many problems for the patient. Therefore, at the first signs of the disease, you should immediately consult a doctor.

Andrologist, Urologist

Conducts examination and treatment of men with infertility. Engaged in the treatment, prevention and diagnosis of diseases such as urolithiasis disease, cystitis, pyelonephritis, chronic renal failure etc.

Testicular torsion- This acute condition, characterized by twisting of the organ around its axis with compression of the spermatic cord. The disease requires emergency assistance urologist. In the absence of adequate therapy, torsion threatens the development and irreversible loss of testicular function.

One of the most common reasons testicular torsion - scrotal injury

IN urological practice There are two conditions that are similar in causes and symptoms:

1. Testicular torsion.

IN the latter case we are talking about twisting and subsequent necrosis of one of the rudimentary processes of the organ. In any of these situations, a mandatory consultation with a urologist is required, followed by treatment and rehabilitation.

This term refers to the twisting of the testicle around its axis. When torsion occurs, the spermatic cord with the vas deferens, vessels and nerves passing through it is compressed. In the literature, this pathology is often referred to as testicular torsion. The disease most often occurs in young boys and teenagers. The peak incidence occurs at the age of 12-16 years. Intrauterine torsion of the spermatic cord is possible, as well as the occurrence of the problem in adulthood and old age.

Causes

There are two main causes testicular torsion:

• pathological organ mobility;
• sudden change in the position of the scrotum.

Excessive testicular mobility may be associated with intrauterine pathology. Often this condition is caused by underdevelopment of the ligaments that fix the testicles to the scrotum. The cause may also be other disorders of the intrauterine development of the organ. There is only one result: the testicle is not attached too tightly to the scrotum and acquires unusual mobility, which leads to its torsion around its axis. Pathological testicular mobility as a cause of torsion is more common in childhood.

Sudden contractions of the scrotum and perineal muscles can also cause testicular torsion. This phenomenon occurs during injury, severe cough and for any sudden movements. There are known cases of torsion during sex and masturbation. The likelihood of this problem increases when wearing tight underwear, as well as in the presence of tumors and other pathological formations of the testicle.

Options

There are three option testicular torsion:

• Extravaginal (extravaginal) torsion– twisting of the spermatic cord above the attachment of the tunica vaginalis of the peritoneum. It is more common in children under one year of age, as well as during intrauterine development.
• Intravaginal (intravaginal) torsion- twisting of the testicle in that part of the spermatic cord that is located inside the vaginal membrane. More common during puberty due to rapid growth organs, as well as in adult men.
• Torsion on the mesentery of the appendage. In this situation, changes affect only the vessels and nerves passing along the mesentery of the epididymis. This option is quite rare.

The type of torsion does not greatly influence the clinical picture of the disease, but determines the tactics of treatment and further management of the patient.

Symptoms

To typical manifestations Testicular torsion refers to:

• severe, sudden, sharp pain in the scrotum area;
• spread of pain to the groin area and bottom part belly;
• nausea and vomiting at the height of an attack of pain;
• swelling and redness of the skin of the scrotum.

The severity of symptoms is variable and depends on the individual sensitivity of the person. Possible increase in body temperature. Loss of consciousness at the time of the attack is possible. Many boys and men experience acute urinary retention. Unpleasant sensations persist for a day, after which the pain subsides. The disappearance of pain is not the most favorable sign and may indicate necrosis of the spermatic cord.

Partial testicular torsion deserves special attention. With this pathology, the symptoms of twisting of the spermatic cord are not too pronounced and disappear on their own within a few hours. The situation repeats itself many times throughout life. Provoking factors can be physical activity, sex or trauma to the scrotum. The possibility of complete torsion of the ovary with the development of all the symptoms of the disease cannot be excluded.

Hydatids are rudimentary formations located on the surface of the testicle and its epididymis. Hydatids are thin round or elongated outgrowths on a stalk. The diameter of one hydatid does not exceed 5 mm. Hydatid torsion occurs mainly in childhood. In adult men, pathology is recorded extremely rarely.

Causes

There are several risk factors hydatid torsion:

• scrotal injury;
• hypothermia;
• heavy physical activity;
• connective tissue pathology;
• disturbances of innervation of the scrotum area.

Torsion of the hydatid occurs when there is a long and thin stalk of the formation. Torsion is promoted by inflammation of the hydatid or disruption of its blood supply. The immaturity of the connective tissue around the testicle also plays a major role. That is why the disease is more common in boys under 7 years of age and is caused by anatomical features child's body.

Symptoms

The following are distinguished: signs hydatid torsion:

• severe pain in the scrotum area;
• irradiation of pain to the lumbar and groin area;
• moderately expressed asymmetric swelling and redness of the skin of the scrotum;
• the appearance of a painful infiltrate at the upper pole of the testicle.

Testicular hydatid torsion begins suddenly with sharp pain in the scrotum. A day later, the pain subsides, and a round, dense formation appears in the upper part of the testicle - a twisted hydatid. Swelling appears later, towards the end of the first - beginning of the second day from the onset of the disease. A characteristic symptom is the symptom of a blue dot - the appearance of a painful compaction that appears through the skin of the scrotum in the form of a cyanotic node.

Complications

Torsion of the testicle or hydatid, if not consulted promptly, can lead to the development of serious complications:

• testicular necrosis (tissue death);
• gangrene of the testicle or scrotum;
• chronic testicular hydrocele.

With inadequate treatment, testicular torsion leads to the development of an inflammatory process in the testicles and subsequent atrophy of the spermatogenic epithelium. In the future, this condition can cause infertility.

Diagnostics

Acute pain in the scrotum area is a reason to immediately consult a doctor. To find out the cause of this condition, the following is carried out:

Examination by a urologist

During the examination, the doctor pays attention to the size and mobility of the testicles, the condition of the skin of the scrotum, and the presence of pain. With torsion, the testicle is located high at the upper edge of the scrotum, which is explained by a pronounced shortening of the spermatic cord. The spermatic cord is thickened. A few hours after the onset of the attack, swelling of the scrotum becomes visible. Secondary testicular hydrocele may appear due to impaired lymph outflow.

Diaphanoscopy is a procedure that helps examine the testicles using a directed source of bright light.

Torsion of the testicular hydatid is accompanied by the appearance of a painful, round lump at the upper pole of the testicles. Swelling and redness of the skin of the scrotum is determined on one side. A characteristic sign is the blue dot symptom (transmission of a twisted hydatid through the tense skin of the scrotum).

Diaphanoscopy

It acquires special significance when hydatid torsion is suspected. Translucent midges with a lamp allow you to see the darkening at the upper edge of the testicle and make a preliminary diagnosis.

Ultrasound

Ultrasound examination allows you to determine the size and position of twisted organs, identify signs of necrosis and bleeding. Doppler testing is required to assess blood flow in the scrotum.

According to indications, the doctor may suggest undergoing scintigraphy ( radioisotope research testicles). IN special cases Diagnostic laparoscopy is performed.

Principles of treatment

The choice of treatment method will depend on the stage of the disease and severity pathological process.

Conservative therapy

Conservative treatment methods are only effective for initial stages testicular torsion (in the first hours from the onset of the disease). External manual detorsion of the testicle is performed with the patient lying on his back.

If testicular torsion is noticed in the first hours, manual reversal (detorsion) can be performed, however, this procedure is considered ineffective

The doctor grabs the testicle along with the scrotal tissue and rotates it outward and downward toward the thigh. The manipulation is repeated several times within two minutes. With a successful procedure, the testicle moves downwards, the pain decreases or completely disappears. If there is no effect from detorsion, emergency surgery is indicated.

Many urologists refuse to perform external testicular detorsion, considering this method traumatic and ineffective. A good result is seen in only 3% of patients; for the rest, surgery becomes an inevitable decision. Previous manual external detorsion can eventually lead to the destruction of the blood-testis barrier, the appearance of sperm antibodies in the body and infertility.

Conservative therapy for torsion of testicular hydatid is not carried out. Once the diagnosis is established, surgical treatment is indicated.

Surgery

Emergency surgery for testicular torsion involves cutting the scrotum (in adolescents and adult men) or groin area(in small children), revision of the wound and manual unwinding of the spermatic cord. During the procedure, the doctor assesses the viability of the organs. When intact spermatic cord the testicle is fixed to the scrotum. In case of severe necrosis, it is carried out.

In case of torsion of the testicular hydatid, a skin incision is made at the upper pole of the testicle. The doctor inspects the scrotum and then excises the altered hydatid. The resulting material is sent for histological examination. Surgical wound sutured in layers.

Rehabilitation

1. Taking antibiotics for prevention infectious complications. Funds are assigned wide range actions in a course of 5-7 days.
2. Taking medications that stimulate microcirculation in the testicles.
3. Sexual and physical rest.
4. Treatment of postoperative wounds with antiseptics.
5. Physiotherapy (UHF, magnetic therapy).

Sutures are removed 7-8 days after surgery. After surgery on the testicle, wearing elastic trunks or a bandage to fix the scrotum is recommended.

Possible complications V postoperative period:

• bleeding;
• secondary infection;
• divergence of seams.

In most cases, the operation is well tolerated and occurs without significant complications. After discharge from the hospital, the patient should carefully listen to his feelings and monitor any changes in well-being. The emergence of such symptoms:

• pain in the area of ​​the postoperative wound that persists for more than 5 days;
• severe swelling of the scrotum;
• bleeding;
• seam divergence;
• the appearance of purulent discharge from the wound;
• increase in body temperature 3-5 days or more after surgery.

If any of these symptoms appear, you should contact your doctor immediately. Delay may lead to development serious complications up to infertility.

Hydatid necrosis of Morgagni is a common but little known disease. The timeliness of surgical treatment is the prevention of infertility in the future.

Testicular hydatid necrosis (or Morgagni hydatid) is a disease characterized by torsion of rudimentary organs on the testicle– Morgagni hydatides – with their subsequent death and possible involvement of the testicles and its appendages in the pathological process.

Hydatid Morgagni is a rudimentary accessory formation formed as a result of testicular embryogenesis with incomplete reduction of the Müllerian duct. The hydatid has a lobular structure, attached to the testicle by a thin stalk.

Causes of the disease

The pathology is common, but little known among the population.

Most often manifests itself in children 4-15 years old. The maximum incidence of the disease occurs in boys aged 10-13 years. During this period, active growth of the testicles occurs, which may be one of the causes of the disease in boys of this age category.

The causative factors are not fully understood. The predisposition to torsion is explained by the special anatomical structure hydatid: thin long stalk of the appendage, loose structure of the hydatid. As a result of torsion, blood and lymph circulation will be disrupted.

Trauma may play a role trigger factor. The acute onset of the disease usually occurs after active physical exertion.

Clinic

1. Initial stage. It manifests itself as constant pain in the scrotum area. The pain appears suddenly and intensifies with physical activity and promotion intra-abdominal pressure(cough, laugh). The duration of the stage is 2-3 days. At this stage, local signs are expressed: swelling, redness of the scrotum, painful sensations in the testicular area. This stage may manifest itself in some categories of patients nagging pain lower sections belly. Therefore, all patients with abdominal pain need to examine the genital organs for torsion of the hydatid of Morgagni. It should be noted that the symptoms may be mild: swelling, hyperemia, and tenderness of the scrotum may be absent or mild. Probably the severity clinical signs depends on the size of the hydatid, the degree of disruption of blood and lymph circulation in it.
2. The stage of the height of the disease. Intensifying local signs defeats. The asymmetry of the scrotum is visually noticeable due to the growth of fluid in the membranes of the testicle. Changes general state(low-grade fever, possible malaise, nausea, vomiting). This period is characterized by the development of acute intense hydrocele of the testicle.
3. Decay stage. Symptoms decrease. The tension of the dropsy decreases. In the area of ​​the testicle, it is possible to palpate a mildly painful infiltrate. Subsidence of symptoms - sure sign hydatid necrosis.

Diagnostics

Diagnosis: carried out by a urologist (https://www.urologist.com.ua/) or a surgeon based on complaints, clinical signs and local changes. To clarify the diagnosis, ultrasound of the genital organs and diaphanoscopy are used.

Ultrasound of the scrotum reveals the location and size of the hydatid. The condition of the testicles and epididymis is also assessed.

Diaphanoscopy - allows you to determine the presence of hydatid in the form of a dark spot and intense dropsy in the form of translucency. Unchanged testicles and epididymis have a red glow.

Treatment

Treatment: exclusively surgical in the first hours of diagnosis of the disease.

In the scrotum, access to the suspected torsioned hydatid is made through a skin incision. An effusion is found in the membranes of the testicle - serous, hemorrhagic or cloudy, depending on the stage of the disease and the addition of infection. The modified hydatid is excised after first ligating its stem. Unmodified hydatides are removed from for preventive purposes. Carry out thorough hemostasis. Self-absorbing interrupted sutures are placed on the skin of the scrotum.

After the operation, anti-inflammatory therapy is prescribed, if necessary antibacterial.

Consequences

The prognosis of the disease is favorable with timely surgical treatment. Testicular function is completely restored after surgery. In advanced cases, secondary ones are formed inflammatory diseases testicles and epididymis, which can lead to obstruction of the vas deferens and cause infertility.

Thus, parents of boys should be aware of such a common disease as necrosis of Morgagni's hydatid, and remember that timely treatment for medical care depends on the condition reproductive system their child in the future.

Hydatids of Morgagni are vestigial structures in men that have the appearance of a cyst-like expansion and are fused to the testicle and its epididymis with the help of tubules or stalks. In a third of men, this residual formation remains, but they may not know about it, since its presence is not accompanied by any sensations. With hydatid torsion, the opposite situation occurs when a man experiences sharp pain and he needs urgent medical attention.

What are testicular hydatides?

Organ laying process genitourinary system in women and men, up to a certain period, it proceeds according to the same laws. In both sexes, in the first stages of development, there is a so-called Müllerian duct, which gives rise to the formation of the uterus, fallopian tubes and vagina. This duct in men is reduced and in their place rudiments are formed, which are called Morgagni hydatids.

Such structures are represented by the expansion of the left or right testicle and its epididymis, which have a cystic shape, their own lobules and tubules connecting the hydatids with the testicles. They can also communicate with the male gonads due to the stalk on which they are located.

Information about the disease

The main reasons for the development of pathology can be:

• scrotal injuries;
• physical exercise;
• loose tissue formation and lack of elastic fibers.

A prerequisite for torsion of the testicular hydatid is the presence of a narrow or long stalk around which the rotation takes place.

The consequence of the incorrect location of the rudimentary formation is a disruption of its blood supply and the development of inflammation.

Symptoms

The reason for a patient's visit to a doctor is certain signs of the disease. When hydatids are affected, they are as follows:

• Sudden, sharp onset of pain, which is localized in the testicle and groin area. Sometimes it can appear in the lower abdomen and spread to the lower back.
• At the top of the testicle or its epididymis, you can feel a painful spherical seal, which is represented by an accumulation of blood or lymph. This infiltrate is visible through the skin and resembles a dark blue nodule. This symptom called the “blue dot”. The place of its formation corresponds to the localization of the twisted hydatid.
• As the pathological process progresses, swelling and redness appearscrotum on the affected side. Therefore it becomes asymmetrical.
• Pathology may be accompanied by fever, nausea and vomiting. This is one of the fastest occurring symptoms.

It is important not to miss the “blue dot” symptom during the first 24 hours, since it is characteristic feature pathology. After 24 hours from the onset of the disease, it is not possible to detect this sign.

Additional Research

To make a diagnosis, doctors conduct examinations, especially when clinical picture It is difficult to establish the fact of the disease:

It makes no sense to expand the search for a modified rudiment, since in this case It is obvious that the patient has an acute process in the testicle. The patient needs to quickly undergo an examination of the organ, during which the nature of the pathology is accurately determined.

Therapy

The main treatment method is surgery. Its main goal is to avoid possible complications, which may appear as follows:

• Chronic hydrocele (hydrocele). The long course of this disease leads to a decrease in blood supply to the testicle, necrosis and atrophy of the gonad.
• Secondary orchiepididymitis. Inflammation in the epididymis, testicle, or both organs immediately leads to the “blocking” of the vas deferens by dead cells, which subsequently causes the man’s inability to fertilize.
• Impaired function of a healthy testicle and its atrophy. Most acute form a disease that can lead to testicular removal.

Main stages surgical intervention:

1. 1. The surgeon dissects all layers of the testicle.
2. 2. During autopsy serous membrane There is a small accumulation of liquid, which may vary in color and transparency. It must be sent for bacterial culture.
3. 3. An enlarged, dark purple or black formation appears in the doctor’s field of vision. This is a modified rudiment. It can be twisted both clockwise and counterclockwise.
4. 4. Next, both the affected and undamaged hydatid are removed.
5. 5. Novocaine and antibiotics are injected into the spermatic cord (if the effusion was cloudy or there are signs of inflammation of the tunica vaginalis of the testicle).
6. 6. A drainage tube is inserted into the scrotal cavity and sutures are placed on the skin.
7. 7. In the postoperative period, anti-inflammatory treatment is prescribed.

If you consult a doctor in a timely manner, the patient’s prognosis for recovery and performance will be favorable.

Torsion of the testicular appendix, together with other pathologies of this organ, is combined into the “acute scrotum” syndrome.

Prerequisites for the occurrence of the disease

The presence of testicular hydatid does not bring any inconvenience to the patient. Many men live with such a vestige, without even suspecting its presence in themselves. However, in some cases, for example, with microtrauma of the scrotum, torsion may occur. IN similar situation necrosis of the hydatid may be observed, manifested by vivid clinical symptoms.

Excessive contraction of the levator testis muscle during sexual stimulation or stimulation low temperatures, can also cause testicular torsion of the appendix.

The overall formation of the tissue around the testicles is of great importance in the occurrence of this disease. This factor determines the incidence of the disease in children and adolescents.. Their stroma contains more fluid, and reflex regulation of muscles is not ideal.

A narrow or long leg, main blood circulation, delicate and loose connective tissue are the main reasons for the development of hydatid pathologies.

Symptoms

When the hydatid is torsed, severe pain appears in the inguinal canal and in the scrotum. Sometimes there is pain in the abdomen and lower back. On initial stage The disease manifests itself as a painful infiltrate in the area of ​​the testicle or epididymis. A little later, redness and swelling appear. The testicle thickens and increases in size.

At the second stage it appears painful lump dark blue color, translucent through the skin, the so-called. "blue dot" symptom. In children, nausea and vomiting can be observed, and in the second stage, fever.

Diagnostics

Clinical diagnosis

Hydatides are not detected by palpation.

Instrumental diagnostics

Diaphanoscopy of the scrotum is the most common method. The method involves shining a flashlight through the scrotum. This makes it possible to detect in it pathological formations. In addition to diaphanoscopy, ultrasonic echography is used. It is necessary not only for diagnosing pathology, but also for determining the location of the incision.

Differential diagnosis

Acute, rare in children, has similar symptoms, however, requires other treatment methods. Therefore, it is necessary to differentiate it from torsion of the testicular appendix.

Introoperative diagnostics

Allows you to detect torsion of the testicular hydatid during inspection of the scrotal organs during surgery. This method allows you to gain time, thereby preventing the development of inflammation. After all, all diseases with “acute scrotum” syndrome are subject to surgical treatment.

Prevention

Preventing the development of this disease is almost impossible. This is due to the fact that patients usually do not realize that they have hydatid torsion. It can only be detected by scheduled inspection see a urologist or andrologist. But even in this case, this education can easily be mistaken for a testicular appendage.

True prevention begins only when it is detected initial symptoms. In this case, it is very important to contact medical assistance in a timely manner, because early start treatment is the key to successful healing.

To prevent the re-addition of enterobacterial flora, broad-spectrum medications are used, such as ceftriaxone and ampicillin.

Complications

Complications of testicular hydatid torsion can only arise in the absence necessary treatment , or if therapy is carried out incorrectly. The initial complication is purulent melting of the hydatid, which results in the formation of purulent exudate in the scrotal cavity, against which epididymitis and secondary orchitis often develop.

In the case of catarrhal inflammation there is Great chance for permission. However at purulent inflammation testicles with appendages, it is possible to perform an operation to remove them.

If the patient does not continue to receive adequate therapy, sepsis or blood poisoning, characterized by heavy sweats, is possible. high temperature, general lethargy and chronic fatigue. The result of this is a toxic coma, which usually ends in death.

Nevertheless, Such complications are not common. Complications that arise during surgery are much more common. For example, damage to the genitofemoral nerve can cause erectile dysfunction, and accidental ligation of the vas deferens can lead to infertility.

Treatment

Non-drug treatment is carried out only when symptoms are not clearly manifested and there is a possibility of regression in the next 24 hours.

The only one effective method Treatment for “acute scrotum” syndrome is emergency surgery. This helps prevent complications such as hydrocele, epididymo-orchitis causing vas deferens obstruction and infertility, testicular dysfunction and atrophy, and secondary nonspecific epididymitis.

For children younger age surgical treatment carried out under general anesthesia, adults and teenagers - under local.
During surgery, the scrotum is cut at the upper pole of the altered testis. Next, all testicular tissue is cut. An examination of the scrotal cavity is performed.

During an audit, as a rule, a bean-shaped compaction of a black or purple hue is detected. The hydatid is clamped at the base, resected, and then subjected to histological examination. Unchanged hydatides are also removed. To prevent intraoperative bleeding, a thread is placed under the clamp and then tied. The wound is sutured in layers. Before suturing, a rubber outlet or drainage is inserted into the scrotal cavity.

Treatment with alternative medicine

Treatment folk remedies with this disease is absolutely excluded.

Compresses and poultices may worsen inflammatory process, spreading the infection not only in the scrotum area, but throughout the body. This is fraught with sepsis or infection of the regula, which can be fatal.

Rehabilitation

Of great importance, in addition systemic use antibiotics such as ceftriaxone and petrexil, in prevention re-infection plays an antiseptic treatment of a postoperative wound. This is carried out using daily disinfectant dressings based on water or alcohol solutions Yoda. Sutures are usually removed a week after surgical treatment.

Since excision of the hydatid testis is not a particularly traumatic operation, there is no particular need to use fixative underwear. However, for older children in the case of epicardial or purulent effusion in the scrotal cavity, the use of a bandage is indicated.

Besides, in some cases physiotherapeutic treatment is recommended, such as galvanization, UHF and magnetic therapy. The sensors of the devices are located on both sides of the scrotum, and the duration of exposure should not exceed twenty minutes, because an increase in temperature in the testicles does not have the best effect on spermatogenesis.

Lifestyle after surgery

After surgery, patients need to avoid colds and other diseases caused by viruses. Even a minor infection can significantly complicate the recovery period.

During surgery, the blood-testis barrier is partially destroyed. This barrier protects the testicular tissue from viruses, bacteria, etc. Therefore, prolonged exposure to low temperatures, be it swimming in cold water, long walks or drinking cold drinks, should be completely avoided until this barrier is completely regenerated.

Forecast

If the inflammation does not occur in the form of sepsis, then the prognosis for recovery is favorable.

The prognosis for life is almost always favorable. Death is possible only in the absence of timely treatment.
The patient's performance, even in those in rare cases when it is necessary to remove the testis, it practically does not suffer.

Torsion of the hydatid testis and epididymis is a disease most often found in children. However, it can also affect young men.