Hydrocoele

(Canal of Nuck = female equivalent of processus vaginalis, projecting into labium majora) 

 

Indications

Symptomatic swelling in adults

 

Procedure

  1. GA + supine position
  2. Access tunica
    • Stretch scrotal skin
    • Incise between visible vessels using either knife or cutting diathermy
  3. Evacuate fluid
    • Make small incision in tunica vaginalis
    • Evacuate the fluid
  4. Repair hydrocoele
    • Jaboulay [tie off sac at apex]: using absorbable sutures, stitch edges of tunica behind cord and subsequently return testis to scrotum
    • Lords [tie off sac around testis]: using series of interrupted catgut sutures bunching up remaining sac around testis before tying sutures and returning the testis to the scrotum.
  5. Close wound with interrupted absorbable sutures