Which is a communicating hydrocele?
|B||Hydrocele of the cord|
a. In infants, hydroceles are fluid collections within the tunica vaginalis or processus vaginalis .
b. During development, the testicles are enveloped by a double layer of peritoneum, which becomes the tunica vaginalis.
c. With normal development, the processus vaginalis, which connects the tunica vaginalis with the peritoneum, becomes obliterated. If the process vaginalis persists, peritoneal fluid can track into the space surrounding the testicles, creating a communicating hydrocele.
d. If bowel tracks down the same space, an indirect inguinal hernia is the result.
e. If the processus vaginalis obliterates and traps fluid in the tunica vaginalis, a noncommunicating hydrocele is the result.
f. Surgical repair is reserved for tense hydroceles that may interfere with testicular circulation or large hydroceles that may cause discomfort.
g. Communicating hydroceles in newborns should generally be observed. Spontaneous closure of the processus vaginalis and resolution of the hydrocele is common; however, hydroceles that persist beyond the first year of life are unlikely to resolve.
h. In pediatric patients, the surgery should be performed through an inguinal incision.
i. The processus vaginalis should be ligated and the distal hydrocele sac should be excised.