Clinical observation on hydrocele and protein fractionation of hydrocele fluid
A hydrocele is a common disease and it can be caused by many etiological factors such as congenintal abnormality, inflammation, trauma, or parasitic infection. The great majority of hydroceles are primary (idiopathic) variety. Hydrocele of the
tunica vaginalis is common in the newborn and most of these fluid collections subside spontaneously during the first few weeks of life. A hydrocele may acutely develop secondary to local injury, acute nonspecific or tuberculous epididymitis or orchitis and it may complicate testicular neoplasm. Chronic hydrocele is common in tropical and subtropical countries where there is a high incidence of filariasis.
Although some investigators have reported that hydrocele-fluid collections are due to lymphatic defect associated with the fluid formation, its mechanism still is uncertain. It is generally known that hydrocele-fluid resembles blood plasma and the most constituent of the hydrocele-fluid is protein. However, little data on properties of the protein are avanable.
The purpose of present studies was to obtain the properties of hydrocele-fluid by means of disc electophoresis and immunodiffusion which are more sensitive method to separate protein fractions. In addition to the studies, clinical observations were performed in order to complete the studies.
In clinical observation, fifty one cartes of hydrocele admitted to the Department of Urology, College of Medicine, Yonsei University during the period from 1969 to 1973 were observed. In persent studies, hydrocele-fluid was collected from the hydrocele sac by aspiration or surgical removal of the sac. Eleven cases of
hydroele were studied during the period from Sep.1973 to Feb.1974. Sera were obtained from the patient of hydrocele.
The total protein of the hydrocele-fluid was measured by biuret method. The protein fraction of the hydrocele-fluid and serum were separated by means of disc electrophoresis. Double diffusion-in-agar-gel was performed according to modified Ouchterlony (1958) method, using 100mm Petri dished covered with 0.85 percent purified agar (DIFCO) in hemagglutinin buffer sol. (pH 7.2). The diameter of a well was 7mm and the distance between wells was 20mm. The agar palates were incubated at 37℃ and the results were observed every day for three days.
The results obtained are summarized as follows ;
1. The incidence of hydrocele is 3.8% to total number of inpatient, 5.4% to total number of male inpatient, and 40.2% to total number of scrotal disease. Hydrocele shows the highest incidence in the scrotal disease.
2. There were 23 cases in the right (45.1%), 24 cases in the left (47.1%) and 4 cases are bilateral (7.8%). Age distribution is between 3/12 and 66 year Vold. The highest incidence of hydrocele is under the age of ten(56.8%).
3. There were 26 cases of primary(51.0%), 17 cases of congenital(33.3%), and 8 cases of secondary hydrocele (15.7%).
4. Total protain of the hydrocele fluid measured by biuret mettled is 4.7gm%.
5. By means of disc electrophoresis, the protein of the hydrocele fluid were separated into 13-17 fractions, which were lesser than that of serum, and the amount of immuno-globulin of the hydrocele fluid was lesser than that of serum.
6. The amount of one fraction in the alpha-2 globulin area of the hydrocele fluid was more than that of serum, and there was one fraction with high density, which was not seen in serum, just below the beta-1 globulin fraction of congenital hydrocele fluid. These fractions were proved the same protein as that of serum by
These findings suggest that hydrocele fluid is originated from blood plasma.