Hydrocele & Varicocele

Question 1

What is the definition of hydrocele?

Answer 1

• A collection of peritoneal fluid within the scrotum around the testes
• Forms when secretion of fluid > absorption

NOTES: In infants, its usually d/t patent processes vaginalis

Question 2

How does hydrocele present?

Answer 2

• Swollen scrotum
  (if swelling fluctuates, suspect
  communicating hydrocele)
• Heaviness/fullness of scrotum
• Usually painless
  (if pain, usually radiates to L back)
• Transilluminated scrotum:
  • fluid appears light pink, yellow, or red

Question 3

How should hydrocele be managed in adults?

Answer 3

• No treatment is required unless provider
  suspects underlying cause, i.e. tumor
• Several possible surgical interventions available
  depending on cause
• Aspiration of hydrocele not done d/t
  re-accumulation of fluid (except for post-op)

Question 4

Define varicocele.

Answer 4

Abnormal degree of venous dilation in spermatic cord above the testes:
- usually on L side
(d/t physiology of L spermatic vein/drainage)

Question 5

How does varicocele present?

Answer 5

Testes:
- pain
- engorgement
- feels like “a bag of worms”

Question 6

Describe varicocele grading.

Answer 6

Grade 1:
- Palpable only with valsalva maneuver

Grade 2:
- Palpable when standing

Grade 3:
- Assessed with light palpation and
visual inspection

Question 7

How is varicocele managed?

Answer 7

Referral to surgery/urology

NOTE: Often found secondary to fertility problems. Surgery/treatment does not guarantee of improvement in fertility/sperm count