Hydrocele

Question 1

What is a Hydrocele?

Answer 1

An accumulation of fluid within the tunica vaginalis, can be communicating and non-communicating

Question 2

What is a communicating hydrocele?

Answer 2

Caused by patency of the processus vaginalis, allowing peritoneal fluid to drain down into the scrotum.
Common in newborn males 5-10%, usually resolve within first few months of life.

Question 3

What is a non-communicating hydrocele?

Answer 3

Caused by excessive fluid production within the tunica vaginalis.

Question 4

What conditions can a hydrocele develop secondary to?

Answer 4

Epididymo-orchitis
Testicular torsion
Testicular tumours

Question 5

What are the features of a hydrocele?

Answer 5

Soft, non-tender swelling of the hemi-scrotum. Usually anterior to and below the testicle.
Swelling is confined to the scrotum, you can get ‘above’ the mass on examination
Trans-illuminates wit a pen torch
The testis may be difficult to palpate if the hydrocele is large

Question 6

What investigation can be done for hydrocele?

Answer 6

Ultrasound

Clinical diagnosis but can be done to confirm if there is doubt

Question 7

What is the management of hydrocele?

Answer 7

Infant hydroceles are generally repaired if they do not resolve spontaneously by the age of 1-2 years
In adults a conservative approach may be taken depending of the severity of the presentation. Further investigation (e.g. ultrasound) is usually warranted to exclude any underlying cause such as a tumor