074 HYDROCELE, HEMATOCELE, AND VARICOCELE. 



seen in by far the greater number of cases unaccompanied by 

 hydrocele. 



Symptoms. Hydrocele with hematocele of the tunica vaginalis 

 sometimes presents a striking resemblance to inguinal hernia. The 

 swelling is often very marked (Steffen saw a goat in which the scrotum 

 reached nearly to the ground), but is soft, elastic, often painless 

 and free from inflammatory symptoms. The condition is distin- 

 guished from rupture by the fact that swelling is confined principally 

 to the lower part of the scrotum ; above, the scrotum tapers away 

 and shows no abnormal distension, because the fluid is easily dis- 

 placed. By compressing the upper part of the scrotum fluctuation 

 may easily be detected at the base. 



In large animals the presence of inguinal hernia can also be 

 determined by examination per anum. In hydrocele of the spermatic 

 cord such examination may be necessary to confirm the diagnosis, 

 as the form of the swelling often greatly resembles that of a hernia. 

 If absolutely necessary, an exploring needle may be passed into the 

 scrotum. 



This disease is distinguished from sarcocele by the less firm 

 swelling, and by the smaller size of the testicle, which as a rule appears 

 atrophied. 



Prognosis is favourable in as much as life is not threatened, but 

 recovery with conservation of the testicle is generally doubtful. 

 Early treatment of hematocele and hydrocele is often successful ; 

 complication with inguinal hernia renders the condition grave. 



Treatment. Velpeau was the first to employ injections of iodine 

 for hydrocele, and they are still used in man. Simple puncture 

 seldom succeeds. Stephen emptied the tunica vaginalis of a ram 

 fourteen times, but it always filled anew ; nor was puncture with 

 injection of iodine solution more successful. Antiseptic precautions 

 must, of course, be observed. When employing this method, the 

 tincture of iodine should be freshly prepared, the tunica vaginalis 

 emptied of its contents, and the solution injected and allowed to 

 remain ; afterwards a suspensory bandage with antiseptic packing 

 should be applied to the scrotum. Great swelling follows, but 

 subsides after six to eight days. 



Castration is more certain if the diseased portions of the spermatic 

 cord be removed with the testicles ; if properly performed, healing 

 generally results. Operation must, however, be delayed until acute 

 inflammatory symptoms have subsided. In castrating four sucking- 

 pigs affected with periorchitis and hydrocele, Hess lost two ; it was 

 remarkable that of five of a litter, four suffered from hydrocele. 



