ⓘ Hydrocele testis. A hydrocele testis is an accumulation of clear fluid within the cavum vaginale, the potential space between the layers of the tunica vaginalis ..

                                     

ⓘ Hydrocele testis

A hydrocele testis is an accumulation of clear fluid within the cavum vaginale, the potential space between the layers of the tunica vaginalis of the testicle. A primary hydrocele causes a painless enlargement in the scrotum on the affected side and is thought to be due to the defective absorption of fluid secreted between the two layers of the tunica vaginalis. A secondary hydrocele is secondary to either inflammation or a neoplasm in the testis.

A hydrocele usually occurs on one side, but can also affect both sides. The accumulation can be a marker of physical trauma, infection, tumor or varicocele surgery, but the cause is generally unknown. Indirect inguinal hernia indicates increased risk of hydrocele.

A hydrocele is normally seen in infant boys, as an enlarged scrotum. In infant girls, it appears as enlarged labia. However, hydroceles are more common in boys than girls.

                                     

1. Signs and symptoms

A hydrocele feels like a small fluid-filled balloon inside the scrotum. It is smooth, and is mainly in front of the testis. Hydroceles vary greatly in size and are typically painless and harmless. However, as the fluid continues to accumulate and the scrotum further enlarges, more discomfort can be expected. Large hydroceles will cause discomfort because of their size. Sometimes pain can be in both testicles as pressure from the enlarged area puts pressure against the unaffected area which can cause discomfort to the normal testicle. It has also been found to decrease a mans sex drive and makes him less active for fear of enlarging the mass. As the fluid of a hydrocele is transparent, light shone through the hydrocelic region will be visible from the other side. This phenomenon is called transillumination.

Symptoms of a hydrocele can easily be distinguished from testicular cancer, as a hydrocele is soft and fluid-filled, whereas testicular cancer feels hard and rough.

                                     

2. Cause

During embryogenesis, the testis descends through the inguinal canal, drawing a diverticulum of peritoneum into the scrotum as it descends. This peritoneal tissue is known as the processus vaginalis. Normally, the communication between the processus vaginalis and the peritoneum is obliterated, and the tunica vaginalis is the tissue that remains overlying the testis and the epididymis. Congenital hydrocele results when the processus vaginalis remains, allowing fluid from the peritoneum to accumulate in the scrotum.

                                     

3. Treatment

The fluid accumulation can be drained by aspiration, but this may be only temporary. A more permanent alternative is a surgical procedure, generally, an outpatient ambulatory same-day procedure, called a hydrocelectomy. There are two surgical techniques available for hydrocelectomy.

Hydrocelectomy with Excision of the Hydrocele Sac Incision of the hydrocele sac after complete mobilization of the hydrocele. Partial resection of the hydrocele sac, leaving a margin of 1–2 cm. Care is taken not to injure testicular vessels, epididymis or ductus deferens. The edge of the hydrocele sac is oversewn for hemostasis von Bergmanns technique or the edges are sewn together behind the spermatic cord Winkelmanns or Jaboulays technique. Hydrocele surgery with excision of the hydrocele sac is useful for large or thick-walled hydroceles and multilocular hydroceles. Hydrocele Surgery with Plication of the Hydrocele Sac The hydrocele is opened with a small skin incision without further preparation. The hydrocele sac is reduced plicated by suture Hydrocele surgery: Lords technique. The plication technique is suitable for medium-sized and thin-walled hydroceles. The advantage of the plication technique is the minimized dissection with a reduced complication rate.

If the hydrocele is not surgically removed, it may continue to grow. The hydrocele fluid can be aspirated. This procedure can be done in a urologists office or clinic and is less invasive but, recurrence rates are high. Sclerotherapy, the injection of a solution following aspiration of the hydrocele fluid may increase success rates. In many patients, the procedure of aspiration and sclerotherapy is repeated as the hydrocele recurs.



                                     
  • A hydrocele is an accumulation of serous fluid in a body cavity. A hydrocele testis is the accumulation of fluids around a testicle. It is often caused
  • lamina visceralis covers the greater part of the testis and epididymis, connecting the latter to the testis by means of a distinct fold. From the posterior
  • an enlarged heterogeneous testis ipsilateral hydrocele thickened scrotal wall and absence of vascular flow in the testis and spermatic cord. The ultrasound
  • The appendix testis or hydatid of Morgagni is a vestigial remnant of the Mullerian duct, present on the upper pole of the testis and attached to the
  • with infertility, inguinal hernia, testicular torsion, epididymitis, hydrocele testis and varicocele. However, it is not clear whether polyorchidism causes
  • the testis usually being normal Hydrocele testis swelling around testes caused by accumulation of clear liquid within a membranous sac, the testis usually
  • chronic 601.9 Prostatitis, NOS 602 Other disorders of prostate 603 Hydrocele 603.9 Hydrocele unspec. 604 Orchitis and epididymitis 604.9 Orchitis epididymitis
  • Spermatocele is a retention cyst of a tubule of the rete testis or the head of the epididymis distended with barely watery fluid that contains spermatozoa
  • Conditions and Procedures: Circumcision, Inguinal Hernia Hydrocele Undescended Testis Hypospadias, Urinary Incontinence, Hydronephrosis, Vesico - Ureteric
  • the different forms of hydrocele of the tunica vaginalis. St This Hosp Rep 1876, 7, 101 118. Notes on diseases of the testis London, 1880. Annotations
  • present in most terrestrial male mammals and located under the penis. One testis is typically lower than the other to avoid compression in the event of impact
  • such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele spermatocele, polyarteritis nodosa, testicular torsion, previous surgery