Urology - Hydrocele Flashcards
What is a hydrocele?
Collection of fluid within the tunica vaginalis
Originally tunica vaginalis is part of the peritoneal membrane, becomes separated during development
What is a simple hydrocele?
Common in new-borns
Fluid trapped in the tunica vaginalis
Usually fluid gets reabsorbed over time and hydrocele disappears
What is a communicating hydrocele?
Tunica vaginalis is connected to the peritoneal cavity via the processus vaginalis
Usually the processus vaginalis obliterates
Fluid is able to travel from the peritoneal cavity into the hydrocele
If the connection is large enough inguinal hernias may occur
How do hydroceles present on examination?
Soft
Smooth
Non-tender swelling
Transilluminates with light
Simple hydroceles- remain same size
Communicating hydroceles- can vary in size
What are some differential diagnoses for scrotal or inguinal swelling in neonates?
- Hydrocele
- Partially descended testes
- Inguinal hernia
- Testicular torsion
- Haematoma
- Tumours
- Epididymitis
How are hydroceles managed?
USS
Useful for confirming diagnosis and excluding other causes, diagnosis usually clinical
Simple hydroceles
Usually resolve within 2 years without negative effects
Parents can be reassured and followed up
May need surgery if any associated problems
Communicating hydroceles
Surgery to ligate or remove processus vaginalis connection if it persists past 2 years old
Large, infected or recurrent hydroceles
Laparoscopic exploratory surgery to rule out secondary pathology
