What is a hydrocoele?
Mar 15, 2005
THEY are not that common in Uganda, but are frequent with our neighbours. On the coast of Tanzania, one can often see men walking around in lesus, with bulges swinging between the legs.
By Paul Semugoma
THEY are not that common in Uganda, but are frequent with our neighbours. On the coast of Tanzania, one can often see men walking around in lesus, with bulges swinging between the legs. One myth is this is not a disease, but a sign of ‘sexual potency’. Local people believe these men have had so much sex that their scrotums have swollen! They consider it a status symbol. Yet it is a disease that slowly develops over years. It affects men and women with swollen genitalia that hung between the legs like footballs.
What happens?
Normally, the heart pumps blood through a closed system of vessels, the smallest being capillaries. The plasma continuously leaks out of the capillaries into the tissue spaces, forming the fluid that bathes all cells in our bodies. Some of this fluid is reabsorbed into blood capillaries. The fluid that fails to get reabsorbed into blood is drained through a system of vessels called lymphatics. Once inside these vessels, this fluid is called lymph. These vessels direct the fluid back to the heart.
When the lymphatics get blocked, the lymph fails to flow. Fluid accumulates between the cells and spaces. This causes swelling of the feet, legs, genitalia and other body parts.
Causes
The most important known cause is tiny worms called filarial, which live within the lymph vessels and gradually cause blockage. These worms, are spread by mosquitoes. The infection may be acquired in childhood, but it takes many years before the swellings occur.
Some people are born with very few lymph vessels. They start having swellings of the legs and feet in late childhood, developing ‘elephantiasis’ .
In some cases, the actual cause of the block never gets to be known.
The result
It is a slow, painless swelling of body parts. The feet and legs may be affected, causing elephantiasis. In men, fluid collects around the testes, forming a hydrocoele. Cells grow in this fluid, forming a slowly increasing solid mass of tissue. The penis is hidden within the huge mass, which may weigh up to 30kg. In women, the vulva lips swell over years, hanging down like testes.
Treatment
Early treatment is very important to kill the worms. A blood test can show who is infected. Drugs kill them, preventing complications. Surgery can remove the huge masses. Because those infected do not feel sick and the disease is very slow, prevention is very important. Using treated mosquito nets prevents infection. Early diagnosis prevents complications. Late treatment is cosmetic, but important.
The writer is a medical doctor
THEY are not that common in Uganda, but are frequent with our neighbours. On the coast of Tanzania, one can often see men walking around in lesus, with bulges swinging between the legs. One myth is this is not a disease, but a sign of ‘sexual potency’. Local people believe these men have had so much sex that their scrotums have swollen! They consider it a status symbol. Yet it is a disease that slowly develops over years. It affects men and women with swollen genitalia that hung between the legs like footballs.
What happens?
Normally, the heart pumps blood through a closed system of vessels, the smallest being capillaries. The plasma continuously leaks out of the capillaries into the tissue spaces, forming the fluid that bathes all cells in our bodies. Some of this fluid is reabsorbed into blood capillaries. The fluid that fails to get reabsorbed into blood is drained through a system of vessels called lymphatics. Once inside these vessels, this fluid is called lymph. These vessels direct the fluid back to the heart.
When the lymphatics get blocked, the lymph fails to flow. Fluid accumulates between the cells and spaces. This causes swelling of the feet, legs, genitalia and other body parts.
Causes
The result
It is a slow, painless swelling of body parts. The feet and legs may be affected, causing elephantiasis. In men, fluid collects around the testes, forming a hydrocoele. Cells grow in this fluid, forming a slowly increasing solid mass of tissue. The penis is hidden within the huge mass, which may weigh up to 30kg. In women, the vulva lips swell over years, hanging down like testes.
Treatment
Early treatment is very important to kill the worms. A blood test can show who is infected. Drugs kill them, preventing complications. Surgery can remove the huge masses. Because those infected do not feel sick and the disease is very slow, prevention is very important. Using treated mosquito nets prevents infection. Early diagnosis prevents complications. Late treatment is cosmetic, but important.
The writer is a medical doctor