Hydrocele

A hydrocele is a common scrotal swelling caused by fluid buildup around the testicle within the tunica vaginalis sac.

Definition and Types

Hydrocele involves serous fluid accumulation between the parietal and visceral layers of the tunica vaginalis, leading to painless scrotal enlargement. Congenital types arise from a patent processus vaginalis allowing peritoneal fluid entry, prevalent in newborns; acquired forms occur in adults due to inflammation or lymphatic obstruction.

Causes and Risk Factors

In infants, it's often developmental as testes descend. Adults face risks from epididymitis, orchitis, filariasis, trauma, testicular tumors, or post-surgical complications like herniorrhaphy. Rarely, it signals underlying malignancy.

Symptoms and Diagnosis

Key signs include a soft, translucent scrotal mass that transilluminates on exam, heaviness, or mild dragging discomfort; pain arises if infected (pyocele). Diagnosis relies on physical exam with light test; ultrasound rules out a hernia, varicocele, or tumor.

Treatment Options

Newborn hydroceles often resolve spontaneously by age 1-2. Persistent or symptomatic cases need hydrocelectomy (excision or eversion via inguinal incision). Aspiration offers temporary relief but risks recurrence and infection.