What are the treatments for scrotal hernia?

I once read a science fiction novel that said that people in the future can clone themselves like cloning sheep. Minor illnesses can generally be treated now, and serious illnesses such as heart disease can be directly transplanted from the cloned heart to their own body. Of course, this goes against human nature, and some people in some countries may have already done this. Here is an introduction to the treatment of scrotal hernia for your reference.

1. Overview

Scrotal hernia accounts for 1% to 2% of male malignant tumors and is divided into primary and secondary types. The vast majority are primary and are divided into two categories: germ cell tumors and non-germ cell tumors. Germ cell tumors occur in the reproductive epithelium of the seminiferous tubules, accounting for 90% to 95% of scrotal hernias. Among them, seminoma is the most common, grows slowly, and the prognosis is generally good; non-seminomas such as embryonal carcinoma, teratoma, and choriocarcinoma are relatively rare, but have a high degree of malignancy, early lymphatic and hematogenous metastasis, and a poor prognosis. Non-germ cell tumors occur in testicular interstitial cells, accounting for 5% to 10%, and originate from testicular interstitial cells such as fibrous tissue, smooth muscle, blood vessels and lymphatic tissue. Secondary scrotal hernia is relatively rare.

The treatment of scrotal hernia depends on its pathological nature and stage, and can be divided into surgery, radiotherapy and chemotherapy.

2. Introduction to treatment methods

1. Radical orchiectomy followed by radiotherapy and/or chemotherapy for seminoma

2. Retroperitoneal lymph node dissection

It is suitable for NSGCT-like scrotal hernia (except choriocarcinoma), seminoma with positive tumor marker (AFP), and mature testicular teratoma in adults. The current surgical method is a modified surgery based on the midline abdominal incision and bilateral retroperitoneal lymph node dissection reported by Mallis and Patton in 1958, such as the expanded unilateral retroperitoneal lymph node dissection. There are also many improvements to the incision, such as the combined thoracoabdominal incision, the combined extrapleural and abdominal incision, etc.

3. Radiation therapy

Different scrotal hernia tissue components have significantly different sensitivities to radiotherapy. Seminomas are sensitive to radiotherapy, while NSGCT-type testicular cancers are less sensitive to radiotherapy, and radiotherapy only plays an auxiliary role. After radical orchiectomy, seminomas are given radiotherapy in the specified lymphatic drainage area according to the stage.

4. Chemotherapy

Scrotal hernia has a good chemotherapy effect and is one of the few tumors that can achieve clinical cure. The chemotherapy effect on seminoma is better than that on NSGCT. It can also be used as adjuvant chemotherapy before and after surgery. Currently, combined chemotherapy is advocated, and there are many chemotherapy plans.

3. Prevention and Care

1. Regardless of whether surgical treatment is performed or not, the factors that increase intra-abdominal pressure, such as chronic cough, constipation, or difficulty in defecation or urination, must be removed first, so as to prevent the hernia from dislodging or reduce the dislodging rate.