Hydrocele

Aetiology:

May be congenital or acquired

Congenital:

• Follow failure of obliteration of the processus vaginalis
• Peritoneal fluid can then enter the scrotum

Acquired:

• The great majority are of unknown origin
• 10% are associated with testicular tumour or infection

Clinical features:

• A infant presents with a large scrotal sac and the hydrocele is easily demonstrated by transillumination
• In adult life, there is a firm, painless transilluminable swelling which it is possible to get above

Management;

Congenital:

• Majority resolve by the age of 3 years
• Persistence beyond this time requires operative treatment by division and ligation of the processus

Acquired:

• Aspiration is first done to allow examination of the testicle for any underlying cause
• Sometimes this is therapeutic and the hydrocele does not recur
• If it does, surgical excision of the outer wall of the hydrocele is required