Hydroceles
A hydrocele is a condition characterized by an accumulation of fluid between the lining membranes that protect the testicles within the scrotum. This condition occurs in approximately 1 percent of adult males and can sometimes lead to discomfort or noticeable enlargement of the scrotum. In younger males aged eighteen to thirty-five, it is essential to rule out any underlying testicular abnormalities, as hydroceles can sometimes obscure the examination of the testis.
Diagnosis typically involves a physical examination, where a smooth, cyst-like mass can be felt, while the testis itself may not be palpable. A specific sign of a hydrocele is its ability to transmit light when examined, and in cases where the hydrocele is large, an ultrasound may be used to further investigate the presence of testicular issues. Treatment for hydroceles is not always necessary unless symptoms are present. For those requiring intervention, hydrocelectomy, a surgical procedure, is the most effective approach, often performed on an outpatient basis. Other less common treatments include needle aspiration, though this method carries a risk of complications and has a lower success rate. Recurrences of hydroceles after surgery are rare, and most patients can return to normal activities within a week to ten days post-operation.
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Subject Terms
Hydroceles
ANATOMY OR SYSTEM AFFECTED: Genitals, reproductive system
DEFINITION: A collection of fluid between the lining membranes protecting the testicles in the scrotum
CAUSES: Collection of fluid between lining membranes protecting the testicle
SYMPTOMS: Sometimes discomfort, objectionable scrotal enlargement
DURATION: Chronic
TREATMENTS: Surgical removal, if desired
Causes and Symptoms
Hydroceles occur in 1 percent of adult males. In patients between the ages of eighteen and thirty-five, the presence of an underlying testicular must be ruled out. Accurate diagnosis can be carried out through physical examination. A is a smooth, cystlike mass completely surrounding the testicle such that only the mass can be palpated; the testis, inside, cannot be felt. Hydroceles do not involve the spermatic cord. When a light is shined through the cyst, the light is readily transmitted. If the hydrocele is large or tense and the testis cannot be examined, ultrasound examination can eliminate the diagnosis of a testicular abnormality.
Treatment and Therapy
Removal, called hydrocelectomy, is primarily indicated for adult hydroceles that produce discomfort, objectionable scrotal enlargement, or an uncertainty regarding underlying testicular abnormalities upon scrotal ultrasound or physical examination. The presence of a hydrocele does not necessarily require surgical intervention, drainage, or other intervention; it must be accompanied by some significant abnormality to require surgery.
Surgical excision is the most effective method for treatment and can be done on an outpatient basis. A 5.0- to 7.6-centimeter (2.0- to 3.0-inch) incision is made in the scrotum, and the wall of the hydrocele is identified and dissected free. The hydrocele sac is removed and its edges sewn or cauterized to eliminate bleeding. The testis is then returned to the scrotum, and the incision is closed. For large hydroceles, a small drainage tube is introduced into the to limit swelling.
The most frequent of hydrocele surgery is scrotal swelling, which may continue for eight weeks. Most patients return to full activity within seven to ten days of surgery, however, and recurrences are rare.
In addition to surgical removal, other treatment options include needle and aspiration with the injection of sclerosing agents. Needle aspiration is rarely effective and increases infection risk. Fluid usually reaccumulates within three months of aspiration. Aspiration with the injection of sclerosing agents such as tetracycline is successful in fewer than 50 percent of patients and usually requires multiple treatments.
Bibliography
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