A significant portion of the department's activity is focused on performing corrective surgeries for hydrocele or inguinal hernia in children. This is a highly common issue among children that sometimes requires immediate intervention to prevent serious complications.
In a child, hydrocele manifests as an accumulation of fluids around the testicle. During pregnancy, the testicle is situated inside the abdomen. Around the 28th week of pregnancy, the testicle starts to descend into the scrotum. The hernia opening through which the testicle descends is supposed to close around 72 hours after birth. In 20% of cases, the hernia remains open even after 72 hours and effectively connects the scrotum to the abdominal cavity. Since there is always fluid present in the abdominal cavity, this fluid can pass through the open hernia opening into the scrotum. In most cases, if the hernia does not close after birth, it will close within the child's first year. If the hernia remains open even after the child's first year, surgery is required to close the hernia to prevent potential complications, such as the entry of abdominal contents (like a loop of intestines) into the hernia, causing an incarcerated hernia that requires urgent treatment.
If surgery is decided upon, the child undergoes general anesthesia and stays at the hospital for a day. The surgery is performed through a 2cm incision in the hernia area, during which the hernia sac connecting the scrotum and the abdominal cavity is tied while preserving the spermatic cord and blood vessels of the testicle. At the end of the surgery, the incision is closed using an adhesive that allows for satisfactory cosmetic results. The child can return to normal activities (going back to preschool or school) after a few days. The incision can be dampened the day after the surgery. The plaster/dressing can be removed after 5 days if it doesn't come off by itself after bathing.
The appearance of redness in the wound or oozing from the surgery area requires an immediate visit to the triage room or the pediatric urology clinic to receive treatment for a possible infection in the surgery area. If there are loops of intestines within the hernia sac or around the testicle, this indicates an inguinal hernia rather than a hydrocele. In such cases, immediate surgery is performed upon diagnosing the hernia to prevent entrapment of the intestines within the hernia sac. The surgery is performed in a similar manner to hydrocele surgery, and the post-operative recommendations are also similar.