hydrocoele

Question 1

definition

Answer 1

Hydrocele is a collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck. There are 2 types of hydroceles: communicating and non-communicating (simple).

In communicating hydroceles, a patent processus vaginalis connects the peritoneum with the tunica vaginalis, which allows peritoneal fluid to flow freely between both structures. If the connection is large, abdominal contents (bowel, bladder, or omentum) may enter the groin, and this complication is termed an inguinal hernia. Inguinal hernias are classified into either direct or indirect, based on the relationship of the sac to the inferior epigastric artery. In a direct inguinal hernia, the hernial sac lies medial to the artery and the deep inguinal ring. In an indirect inguinal hernia, the hernial sac lies lateral to the artery (see our full content on inguinal hernia).[1]

A non-communicating or simple hydrocele occurs when the processus vaginalis is closed and more fluid is being produced by the tunica vaginalis than is being absorbed.

Question 2

symptoms

Answer 2

• scrotal mass (The mass is likely to be soft if the communication is large or tense if it is small. It may be restricted to the scrotum or it may extend into the inguinal canal.)
• transillumination
• enlargement after activity (e.g. coughing, straining, crying, raising arms)
• variation in size of mass throughout the day

Question 3

investigations

Answer 3

1st:
- clinical diagnosis

others:
scrotal ultrasound