Question

Lord's plication is done for:

• A. Inguinal hernia
• B. Testicular cancer
• C. Hydrocele
• D. Testicular varices

Hint:

Think of the operation that pleats the tunica vaginalis to stop fluid collecting around the testis.

Answer 1

The Correct Option is C

Step 1: Identify the procedure. Lord's plication is an operation for a hydrocele, which is an abnormal collection of serous fluid within the tunica vaginalis surrounding the testis.

Step 2: Understand the technique. In Lord's plication the sac is opened through a small scrotal incision and a series of interrupted sutures (plication stitches) are placed radially from the edge of the opened sac toward the testis. Tying these sutures bunches the redundant tunica into a ruff around the testis, so the secreting surface is obliterated and fluid no longer collects.

Step 3: Note when it is preferred. Lord's plication suits a thin-walled hydrocele sac because there is minimal dissection, little dead space, and therefore a low risk of haematoma compared with the Jaboulay procedure (eversion of the sac), which is better for a thick-walled sac.

Step 4: Reject the distractors. Inguinal hernia is repaired by herniotomy or mesh repair, not plication. Testicular cancer is managed by radical inguinal orchidectomy. Testicular varices (varicocele) are treated by varicocele ligation or embolisation.

Answer: Hydrocele (Option C).