Bergman's operation can be recommended for testicular dropsy. During surgery, excess fluid is removed that interferes with the normal life of a man. Bergman's operation for dropsy of the testicle is more often prescribed for adult patients than for children. Surgical intervention allows you to save a diseased organ and subsequently have offspring.
Testicular dropsy
Hydrocele is a condition in which a man begins to accumulate excess fluid near the testicle. Sometimes the disease goes away on its own, but in some cases, surgery is indispensable. The condition usually does not cause any discomfort, but it can cause testicular pain in a man. Most often, a person falls ill with a hydrocele between the ages of 15 and 30.
Testicular dropsy is divided into several forms:
- congenital;
- acquired;
- postoperative.
Before birth, the testicles of the boy are in the abdominal cavity, but by the time of birth they shoulddescend into the scrotum. Premature babies have a fairly high chance of getting hydrocele due to natural causes. Dropsy of the testis may be acquired. Most often it occurs for the following reasons:
- heart failure;
- tuberculosis;
- inflammatory process in the scrotum;
- genital injury;
- tumor;
- infectious disease;
- infection with some types of helminths.
To the acquired dropsy of the testicles, the elderly men are most located. Bergman's surgery for hydrocele in adults has a good chance of a full recovery.
Symptoms of hydrocele
In patients, the scrotum always increases in size. If a man tries to feel the testicles in her, then he will not be able to do this. Such a situation cannot but cause anxiety in the patient. Although a hydrocele can cause testicular pain in men, most often the disease is asymptomatic.
Sometimes the affected organ grows so much that it ceases to fit into clothes normally. In this case, the patient's condition is complicated by rubbing of the scrotum and a feeling of discomfort in the genitals. In some cases, patients experience a violation of urination. It becomes difficult for a man to lead a normal life, sexual intercourse with a partner can be difficult.
Some patients complain of a feeling of heaviness and squeezing that haunts them at any time of the day or night. In the evening, the edema in a man increases, so hisfeeling worse. Some patients complain of insomnia caused by the state of discomfort.
Examination
The patient is recommended to undergo an ultrasound procedure, in which the doctor will be able to assess the condition of the testicle itself and its appendages, as well as the volume of fluid. After that, a consultation with a qualified urologist will be necessary. The doctor will need to differentiate the hydrocele from other similar diseases. Only a correct diagnosis can serve as an indication for Bergman's operation.
Diseases sharing symptoms with dropsy:
- varicocele;
- testicular tumor;
- cyst;
- hernia;
- epididymo-orchitis.
A tumor differs from dropsy of the testicle in that a volumetric neoplasm can be felt in the scrotum. A hernia can be pushed back into the abdomen, but a hydrocele cannot. To confirm the diagnosis, urologists recommend an ultrasound examination.
Indications for surgery
A man should be careful and, with a sharp increase in hydrocele, consult a doctor who is likely to prescribe an operation. In some cases, surgery is necessary because conservative treatment is not possible. Main indications for Bergman operation:
- large non-communicating hydrocele;
- thickening of testicular membranes;
- a sharp increase in the volume of the scrotum;
- presence of comorbidities.
If, in preparation for a surgical intervention, a patient is found to haveinfectious disease, then the operation is postponed for a month. If the patient has festering wounds, doctors wait for their complete healing. As soon as the signs of inflammation have disappeared, the patient is immediately operated on. The decision on the time of intervention is made only by the doctor after a thorough study of the initial data.
Preparation for surgery
Before surgery, patients are given a list of tests that they need to pass. The operation is being carried out as planned. Tests that are usually required by a doctor:
- HIV;
- hepatitis;
- syphilis.
If necessary, before the operation, the patient is referred to a cardiologist, gastroenterologist and other specialists. The patient must receive the results of an X-ray examination of the chest. Often, the doctor will also recommend that the patient undergo an electrocardiogram. In preparation for Bergman's operation, the patient undergoes an ultrasound examination of the scrotum.
A week before surgery, the doctor agrees with the patient on the medications he takes. Some medicines are canceled, as they can affect the result of the operation and complicate its implementation. Before surgery, the patient removes hair in the groin area and thoroughly cleans the genitals. In the morning, the patient is forbidden to have breakfast, the operation is performed on an empty stomach. After registering the patient, the doctor of the emergency room directs him to the ward. There the patient is waiting for surgery.
Methodology
Bergman's operation is usually recommended in cases where the testicle has greatly increased in size. Then part of its shell is removed, and the remaining tissues are sewn together. Description of Bergman's operation:
- The patient is asked to lie on his back. After that, the medical staff begin to process the surgical field.
- The area to be surgically treated is anesthetized. For anesthesia, the most commonly used drugs are Novocain or Lidocaine.
- The surgeon makes an incision in the scrotum in the area of the connecting suture. The resulting hole is 5-6 cm long. It is located in the anterior region of the scrotum.
- The surgeon cuts the membranes in layers and at the same time stops the bleeding from the vessels.
- After the doctor pushes the testicle back and removes excess fluid with a syringe.
- Then the surgeon excised the vaginal membrane. The doctor returns the testicle to its place and stitches the tissues in layers.
The wound is drained, after which a napkin is applied to it. The surgery is usually uneventful.
Post-op care
After a surgical intervention in the scrotum for some time there is a drain through which the resulting fluid is removed. Bandages are applied to the patient for several days. If absorbable sutures were used during surgery, then there is no need to remove the sutures.
The postoperative period during Bergman's operation requires bed rest. This is necessary even ifif the patient feels well. In order for the seams to grow together safely, it is necessary to exclude situations in which the tissues will strain. The doctor conducts a daily examination of the patient. He makes sure that the wound surface heals well and does not become inflamed. The sterile drape should be changed regularly to avoid complications.
It is very important to eat light foods rich in fiber, this will improve bowel function. If the patient pushes excessively during bowel movements, the sutures may come apart. The patient after the operation must perform all hygiene procedures recommended by the doctor.
Complications
The Bergman operation is often used by doctors, so there are usually no problems when performing it. Complications after surgery in patients are extremely rare. The most common consequence for the patient is pain, but it most often passes quickly enough. If discomfort continues for a long time, then this should be reported to the doctor. Complications that may occur after Bergman's operation:
- seam divergence;
- swelling of the tissues of the scrotum;
- keloid scars;
- hematomas;
- wound infection;
- re-accumulation of fluid;
- testicular atrophy.
Seam divergence may occur due to rejection of the filament material. In some cases, the cause of this complication is the wrong behavior of the patient. If hematomas occur after surgery, then you should notworry. They usually disappear completely after a few weeks.
Contraindications
Not all patients can be operated on by Bergman, sometimes it is better to choose a different surgical technique. It is contraindicated in men suffering from serious pathologies of the cardiovascular system. It is especially dangerous to prescribe Bergman's operation during acute myocardial infarction. Surgical intervention is also contraindicated for problems with the respiratory system.
If a man has recently had an infectious disease, then Bergman's operation is postponed for at least 30 days. It is contraindicated in any purulent processes, including abscesses, furunculosis, inflamed wounds. The decision on the advisability of surgical intervention in all cases is made by the doctor.
