Causative & risk factors
Both the testes are suspended downwards from within the abdominal cavity. Each testis is enclosed in a sac. In newborn boys, the sac closes and the fluid gets absorbed. Sometimes the fluid can remain unabsorbed, leading to development of hydrocele of the non communicating type. In communicating hydrocele, the sac remains open. These openings usually close within a year of birth and the fluid gets reabsorbed. Hydrocele that occurs in a newborn is also known as fluid hernia.
Hydroceles that appear after birth are caused due to injury to the groin area, epididymitis or testicular cancer.
Clinical presentation
Hydrocele does not produce pain per se. However it can cause discomfort due to its size and heaviness. The quantity of fluid in a hydrocele may vary from as little as 50 cc to as much as 2 liters. Very rarely, hydrocele can cause redness, swelling or pain in the scrotum. Hydroceles may be associated with an inguinal hernia.
Investigations
Your doctor will perform a physical exam of the scrotum and abdomen. He will perform a trans-illumination test. In this test, a light is shone behind each testicle. In cases of hydrocele, the light should shine through the scrotum.
Certain blood tests, urine test and an ultrasound of the scrotum will be carried out.
Treatment
In newborns, hydrocele usually disappears within a year.
In adults, surgery is the only treatment for hydrocele. Hydrocelectomy is carried out to remove the hydrocele under anesthesia.
In men who cannot have surgery, aspiration of the hydrocele fluid can be done. However hydroceles tend to recur in these cases.
Recent updates
It is common for hydroceles to occur after undergoing repair for varicocele. A recent study suggests that lymphatic sparing should be done while undertaking varicocele repair in order to prevent the development of hydrocele.
