Hydrocele

Question 1

What is a Hydrocele?

Answer 1

Excessive collection of serous fluid within the tunica vaginalis or along the spermatic cord
Congenital (most paed cases) or acquired

Question 2

What are the 2 types of acquired hydrocele?

Answer 2

Non-communicating: same size or very slow growth

Communicating: doesn’t go away until you treat it + can lead to an inguinal hernia

Question 3

List 5 causes of non-communicating hydroceles

Answer 3

Trauma  
Infection  
Testicular torsion  
Epididymitis  
Varicocele op

Question 4

List 3 causes of communicating hydroceles

Answer 4

Peritoneal dialysis
Ascites
CT disorders

Question 5

Describe the epidemiology of hydroceles

Answer 5

VERY COMMON in CHILDREN in 1st year of life: usually resolve spontaneously
Common in older men

Question 6

Give 2 symptoms of hydroceles

Answer 6

Usually ASYMPTOMATIC
Scrotal swelling
May complain of pain or urinary sx due to underlying cause

Question 7

List 4 signs of hydroceles

Answer 7

Scrotal swelling: increases in size with certain activities e.g. coughing, straining, crying or raising arms
Possible to get above the swelling
Transilluminates
Difficult to separate the swelling from the testicle

Question 8

How are hydroceles diagnosed?

Answer 8

CLINICAL DIAGNOSIS

Question 9

What investigations may be performed for hydroceles?

Answer 9

Ultrasound: exclude tumour
Urine: dipstick + MSU for infection
Blood for markers of testicular tumours: a-fetoprotein, b-HCG + Lactate dehydrogenase

Question 10

List 5 risk factors for the development of hydroceles

Answer 10

Indirect inguinal hernias in children  
Prematurity + low birth weight  
Infants who testes descend late  
Epididymo-orchitis  
Filariasis (in countries with high prevalence)