Clinical Observation on Hydrocele and Protein Fractionation of Hydrocele Fluid

Lee, H S; Lee, J M

Abstract

A hydrocele is a common disease and it can be caused by many etiological factors such as congenital abnormality, inflammation, trauma, or parasitic infection. The great majority of hydroceles are primary (idiopathic) variety. Hydroele of the tunica vaginalis is common in the newborn and most of these fluid collection 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 an properties of the protein are available. The purpose of present studies was to obtain the properties of hydrocele-fluid by means of disc electrophoresis 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 cases of hydrocele admitted to the Department of Urology, College of Medicine. Yonsei University during the period from 1969 to 1973 were observed. Hydrocele-fluid was collected from the hydrocele sac by aspiration or urgicals removal of the sac. Eleven cases of hydrocele 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. Doubles diffusion-in-agar-gel was performed according to the modified Ouchterlony (l958) method using 100mm Petri dishes covered with 0.85 percent purified agar (DIFCO) in hemagglutinin buffer solution (pH 7.2). The diameter of a well was 7mm and the distance between wells was 20mm. The agar plates were incubated at 37 C and the results were observed every day for three days. The results obtained are summarized as follows: 1. The incidence of hydrocele was 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 showed 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 were bilateral (7.8%). Age distribution was between 3/12 and 66 year-old. The highest incidence of hydrocele was under the age of ten (56.8). 3. There were 26 cases of primary (51. O%). 17 cases of congenital (33.3%), and 8 cases of secondary hydrocele (15.7%). 4. Total protein of the hydrocele fluid measured by biuret method is 4.7gm%. S. By means of disc electrophoresis, the protein of the hydrocele fluid were separated into 13-17 fractions, which were less then that of serum, and the amount of immunoglobulin of the hydrocele fluid was less 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 double diffusion-in- agar-gel. These findings suggest that hydrocele fluid is originated from blood plasma.