2014
DOI: 10.5489/cuaj.1938
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The use of TPA in combination with alcohol in the treatment of the recurrent complex hydrocele

Abstract: A hydrocele is an abnormal collection of serous fluid in the space between the parietal and visceral layers of the tunica vaginalis. Hydrocele is the most common cause of painless scrotal swelling which affects about 1% of men. Generally, adult hydroceles are idiopathic in origin; however, inguinal surgery, varicocelectomy, infection, trauma and a patent processus vaginalis are each associated with the subsequent development of a hydrocele. Surgical removal of hydroceles is the gold standard of care. However, … Show more

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Cited by 5 publications
(4 citation statements)
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“…At MDT discussion of the case one of the proposed reasons for the missed diagnosis was the fact that the extended cystic part of the tumor gave a very hypoechoic image on US mimicking the hypoechoic fluid accumulation seen in a typical hydrocele. On the other hand, it was noted that complex hydroceles usually result from previous failed hydrocelectomies or infected hydroceles and very rarely in de novo cases (14). Irrespective of the aetiology, misdiagnosis of a testicular tumor as a complex hydrocele has significant implications in surgical planning as a scrotal incision used for hydroceles is contraindicated in cases of suspected testicular malignancy, and also for patient counselling (2,9,15).…”
Section: Discussionmentioning
confidence: 99%
“…At MDT discussion of the case one of the proposed reasons for the missed diagnosis was the fact that the extended cystic part of the tumor gave a very hypoechoic image on US mimicking the hypoechoic fluid accumulation seen in a typical hydrocele. On the other hand, it was noted that complex hydroceles usually result from previous failed hydrocelectomies or infected hydroceles and very rarely in de novo cases (14). Irrespective of the aetiology, misdiagnosis of a testicular tumor as a complex hydrocele has significant implications in surgical planning as a scrotal incision used for hydroceles is contraindicated in cases of suspected testicular malignancy, and also for patient counselling (2,9,15).…”
Section: Discussionmentioning
confidence: 99%
“…The surgical management of communicating hydrocele is similar to that of the indirect inguinal hernia, where correction and resections are used, and therefore, this can lead to a miscommunication with the peritoneal cavity [28]. Using catheter drainage with thrombolytic therapy and alcohol ablation has also been effectively reported in the literature for the management of complex recurring cases [29]. Furthermore, the surgical management of communicating hydrocele is to induce a significant ligation of the processus vaginalis at a level that corresponds to the internal inguinal orifice and to create a fenestration within the homolateral tunica vaginalis.…”
Section: Literature Reviewmentioning
confidence: 99%
“…Данную методику используют на протяжении нескольких де-сятилетий, однако по многим причинам широкого применения она не получила [23]. Механизм склероте-рапии идентичен таковому при применении большин-ства склерозантов и связан со стимуляцией инородным веществом воспалительной клеточной реакции, приво-дящей к слипанию листков собственной влагалищной оболочки.…”
Section: оперативные методы лечения гидроцелеunclassified