foreign [Applause] [Music] tofinals.com in this video I'm going to be going through Hydra seals and you can find written notes on this topic at xerodifinals.com scrotal lumps or in the Urology section of the zero to finals surgery book so let's jump straight in a hydrocele is a collection of fluid within the Tunica vaginalis that surrounds the testes hydroceles are usually painless and they present with a soft scrotal swelling the Tunica vaginalis is a sealed pouch of membrane that surrounds the testes originally the tunic of adenalis is part of the peritoneal membrane and during fetal development it becomes separated from the peritoneal membrane and it remains in the scrotum partially covering each testicle let's talk about examination findings with a hydrocele when a patient has a hydrocele the testicle will be palpable within the hydrocele they are soft fluctuant and they can be quite large the lumps will be irreducible and have no bowel sounds which can help distinguish it from a hernia and you can transilluminate a hydrocele by shining a torch through the skin into the hydrocele into the fluid causing it all to light up and you may be able to see the testicle floating within the fluid hydroceles can be idiopathic with no apparent cause or they can be secondary to testicular cancer testicular torsion epididymo or kitis or infection or due to trauma to the testicles management of hydroceles involves excluding serious causes such as testicular cancer idiopathic hydroceles may be managed conservatively meaning no active treatment is required if the patient has a large or asymptomatic hydrocele then the options are surgery aspiration or sclerotherapy if you like this video consider joining the zero to finals patreon account where you get early access to these videos before they appear on YouTube you also get access to my comprehensive course on how to learn medicine and do well in medical exams digital flash cards for rapidly testing the key facts you need for medical exams early access to the zero definals podcast episodes and question podcasts which you can use to test your knowledge on the go thanks for watching and I'll see you in the next video