Hydrocele Flashcards
What is it?
A collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord.
Epidemiology?
Common in male infants and the newborn. Most paediatric hydroceles are congenital and, in the majority of cases, resolve within the first year of life.
May occur in adult men secondary to minor trauma, infection, testicular torsion, epididymitis, varicocele operation, or testicular tumour.
Aetiology?
Non-communicating hydroceles are found secondary to minor trauma, infection, testicular torsion, epididymitis, varicocele operation, or testicular tumour.
Communicating hydroceles may occur following increased intra-abdominal fluid or pressure (due to shunts, peritoneal dialysis, or ascites) if there is a patent processus vaginalis.
Patients with connective tissue disorders have a high risk of communicating hydroceles. Hydroceles may also be seen in patients with filariasis as a result of lymphatic obstruction.
Risk factors?
Late descending testes in infants
connective tissue disorders
ascites everything mentioned prior
what are the presenting symptoms of hydrocoeles?
Scrotal mass - will enlarge with activity if communicating hydrocele
Variation in scrotal mass during day; the size of the mass will be smaller in the morning and after lying down than in the evening.
Usually ASYMPTOMATIC
Patients may complain of pain or urinary symptoms due to the underlying cause i.e. torsion
Signs on examination?
Transillumination
Scrotal swelling
It is possible to get above the swelling
Difficult to separate the swelling from the testicle
Smaller size with lying down?
Investigations?
It is a clinical diagnosis - via hx and examination
no ivx needed but can do;
Scrotal US; confirms presence or absence of normal/abnormal testis
Urine - dipstick and MSU for infection
Blood - markers of testicular tumours:
a-fetoprotein
b-HCG
Lactate dehydrogenase
