Descent of testis, hydrocele

Surgery needs anatomy so badly!!

Need to revise………hope ill remember this forever.

In a nutshell, about the descent of the testis.
Testis is like a balloon attached to its thread(gubernaculum) which is ‘tied’ to the scrotum. Yes… So a balloon with the thread attached to the scrotum. Lol

And it pulls it down and anterior passing through the inguinal canal and then the scrotum.

That is the most simple explanation for the descent of testis.haha.

Oh yes, the thread is not only attached to the testis but also the peritoneum in front of testis and tail of epididymis.

So… Its attachment to the peritoneum forms processus vaginalis which obliterates a few weeks before birth till a few weeks after birth.

So… Note that in premature infants patent PV is more common and also undescended testis.

IF YOU FIND AN EMPTY BAG(scrotum )

There are several possibilities:
Undescended testis
Ectopic
Retractile
Hypoplastic
Anorchia
Atrophy

The doctor said that in both congenital inguinal hernias and hydrocele both have patent PV, only the neck is wider in hernias.

My question is, how to DDx congenital hydrocele with hydrocele of hernial sac???

Hmm…Im not that sure…i asked the dr just now but i cant seem to understand it clearly.

Remember!!! In tense hydrocele,(when we cant indent our fingers) we must do surgery, for fear of impaired blood supply.

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