HYDROCELECTOMY

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A hydrocelectomy is a surgical procedure used to correct a hydrocele. A hydrocele is a condition in which fluid collects in the sac around the testicle, leading to swelling and discomfort. Hydroceles can occur in males of any age, but they're most commonly seen in newborns and older men.

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The hydrocelectomy procedure usually involves the following steps:

1. Anesthesia: The patient is given general or spinal anesthesia to prevent any discomfort during the procedure.

2. Incision: The surgeon makes an incision in the scrotum or the inguinal area (just above the scrotum).

3. Drainage of fluid: The surgeon then drains the fluid from the hydrocele sac.

4. Sac treatment: The hydrocele sac may be removed, stitched up or turned inside out and stitched to the back of the testicles (this method is known as the Jaboulay procedure). The choice depends on the surgeon's judgement and the specifics of the case.

5. Closure: The incision is then closed with sutures.

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Recovery from a hydrocelectomy is generally quick. Patients are often able to go home the same day as the surgery, but there may be instructions to follow, like wearing supportive undergarments and refraining from sexual activity for a certain period of time.

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                                                            Anesthetic Implications for Hydrocelectomy

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Anesthesia type: General, neuraxial

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Airway: LMA or ETT

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Preoperative:

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• A hydrocele may be accompanied by an inguinal hernia

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Intraoperative:

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• Manipulation of the genitals can cause sudden and significant vagal bradycardia

• Have glycopyrrolate and/or atropine available

• Duration: 30-60 minutes

• Position: Supine or lithotomy, arms at the side on armboards

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Postoperative:

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• A scrotal support strap is applied at the end of the case

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Complications:

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• Infection

• Bleeding

• Injury to the testicle or the structures around it

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Sources:

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Macksey, L. F. (2011). Surgical procedures and anesthetic implications: A handbook for nurse anesthesia practice. 

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Jaffe, R. A. (2020). Anesthesiologist's Manual of Surgical Procedures (6th ed.). 

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Singh-Radcliff, N. (2013). 5-Minute Anesthesia Consult.

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