As has been said, after the closure of the hernial sac a remnant of the abdominal membrane carried along on the descent continues to sur­round each of the testicles as a double-layered sheet. Between those two layers there is normally a small quantity of liquid, which allows the testicle as it were to dance. Sometimes too much liquid is produced between the two layers, which can lead to a very large, uncomfortable

Подпись: Hydrocele.

swelling called a hydrocele. If such a hernia becomes troublesome, for example, when cycling or during sexual intercourse, an operation is called for.

This cabaret song by Hans Dorrestein gives a humorous slant on hydroceles and sex:

Geriatric Sex

Sex for us wrinklies shows the wear and tear, reflects the elderly wife.

God, when will he come, the poor old sod?

His prick’s grown like a goat’s hoof with no hair.

Sex for us wrinklies shows the wear and tear, his scrotum’s like a pouffe that’s full of air.

After forty years it isn’t odd,

growing as close as peas in a pod,

but when this is over I won’t care,

sex for us wrinklies shows the wear and tear.

Hydrocele may be triggered by a previous inflammation of the epi­didymis, a trauma, or in vary rare cases testicular cancer, though in the majority of cases the cause remains obscure. It may be removed either via the groin or via the scrotum. In the latter case an incision is made

in the skin and the next layer, the tunica dartos. Bleeding vessels are held with a fine pincette and cauterized. If the hydrocele is very large, it is first lanced and emptied by suction. The tunica vaginalis is cut open lengthways, so that the testicle itself can be taken out. The redundant layer is removed and folded back behind the epididymis. Because the wall of the hydrocele is turned inside out, the chance of relapse is small. Because of the abundant blood there is a high risk of bleeding after this operation, and partly because of this a pipe is frequently left in through which blood can drain away.