Lecture Notes: Hydrocele

Introduction

• Definition: Hydrocele is the accumulation of fluid around one or both testicles, leading to swelling in the scrotum or groin area.
• Prevalence: Commonly occurs in men over 40 years old.

Types of Hydrocele

• Noncommunicating Hydrocele:
  • Occurs when the sac closes, but the body does not absorb the fluid.
  • The remaining fluid is typically absorbed within a year.
• Communicating Hydrocele:
  • Occurs when the sac surrounding the testicle doesn't close completely.
  • Allows fluid to flow in and out.

Etiology

• Causes:
  • Unknown in many cases.
  • Can be due to inflammation or infection of the epididymis or testicles.
  • Rare cases involve cancer of the testicle or left kidney.
• Risk Factors:
  • More prevalent in men over age 40.

Clinical Manifestations

• Symptoms:
  • Swelling of the scrotum.
  • Pain and redness in the scrotum.
  • Feeling of pressure at the base of the penis.
  • Testicular torsion or infertility in severe cases.

Diagnostic Evaluations

• History and Physical Examination:
  • Essential to start with taking a detailed history and conducting a physical examination.
• Transillumination Test:
  • Performed in a dark room with a bright light to examine structures beneath the skin.
• Ultrasound:
  • Used to confirm the presence of fluid in the scrotum.
• Blood Tests:
  • Conducted to rule out infections.

Treatment

• Surgery:
  • Common for infants if the hydrocele does not resolve within a year or becomes large.
  • Performed by a urologist.
• Needle Aspiration and Sclerotherapy:
  • Aspiration to remove fluid.
  • Sclerotherapy to prevent reaccumulation.
• Prognosis in Adults:
  • Hydroceles typically resolve within six months without intervention.