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 -
  • Patent processus vaginalis, peritoneal fluid flowing between the 2 structures (If connection large enough = inguinal hernia)
  • Cause - Increased intraperitoneal fluid or pressure (shunts, dialysis)
• non-communicating (simple) -
  • Processus vaginal has correctly obliterated. Here, more fluid is being produced in the tunica vaginalis then is being absorbed
  • Cause - minor trauma, infection, testicular torsion, epididymitis

Risk factors:

• Male
• Premature and low birth weight
• Infants <6 months of age
• Testicular cancer
• Connective tissue disorders

Examination

• Scrotal mass -
  • Swelling in front of and below the testicle
  • Soft
  • smooth
  • easily transillumates

Investigations

*Usually a clinical diagnosis

• USS - confirms presence or absence of abnormal testes

Management