Veginal Hydrocele Examination

မတ္တပ္ ရပ္ၿပီးစမ္း ပါ။
Inspection : swelling ; site - (is in inguinal region on R orL side )
size -( __x __ cm in geeatest dimention )
shape(globular ပဲ ၿဖစ္မယ္။ )
extent
surface ( smooth ortense )
ဟိုဘက္လွည့္ ၿပီး ေခ်ာင္း ဆိုးၾကည့္ပါ။ ( cough impalse present or not )
Other side မွာ လည္း ရွိမ ရွိ ေျပာ ပါ ။
skin overswelling - peristalsis waves
-rugaes
-scar (............)
-dilated veins
-ulcers (........)and discharges
-sing of inflammation
Penis - deviated to R orL side and totally sink in huge swelling
Palptation : swelling : temperature
tenderness
Finger can get above above swelling ( hernia မ ဟုတ္ဟု ေျပာ ခ်င္ )
swelling ကို describe လုပ္ပါ ။
...........................................................
consistancy - cystic ( serous fluid ပါ တယ္ ။)

flutation test - positive ( 2 direction by 2finger )
Transillumination test - positive ( see with 180 degree to light source)( ေနာက္ က မီး ထိုး ၿပီး ေရွ့ က ေန ၾကည္ ပါ ။ )
..............................................................
testes : felt separately from swelling ( testiticular tumour မ ဟုတ္ ဟု ေျပာခ်င္ )
normal size and shape
Epididymic & Spermatic cord ; Normal
...................................................................
On other site : no swelling testes can felt normally ( ရွိ ရင္ ေတာ့ ေျပာ ရ မည္ ၊။ )
inguinal Lymph node : not enlarge
left supraclavicular lymph node : not enlarge
..............................................................
Other system ဆက္စမ္း မယ္ ဆို က abdomen ကို စမ္း ပါ ။ paraaortic lymph node and mass ေတြ ရွိ မ ရွိ ေျပာ ရ မည္ ။
........................................................................................................................................................................................................
Diagnosis : _ year old man with ( R /L ) vaginal hydrocele
Differential diagnosis : varicocele
inguinal hernia : reducibility (+)
cough impalse (+)
cannot getabove swelling
Treatment : Transillumination test (+) = thin wall ----> Joboulay,s operation or Peter Lord's operation
Transillumination test (-) = thick wall ----> radical cure by subtotal excision

Complication : ( ဒါ ေတြ ေၾကာက္ လို ့ွ Surgery လုပ္ ရ တယ္ ။)
Torsion
Rupture
Haemorrhage
Infection
Herniation of the sac
Calcification of cyst wall
Testes atrophy
Infertility
Skin ulceration