A hydrocele is an abnormal collection of serous fluid in the tunica vaginalis or another area of the processus vaginali. Older children and adults may get a hydrocele because of an injury in the scrotum or other health problems. This is normally not painful.
1. Clinical features :
- The swelling is usually painless.
- If the testis is gently tugged downward, the enlargement moves downward and becomes less mobile.
2. Pathophysiology :
Hydrocele mainly occurs by four different mechanism :
- Patent processus vaginalis gets connected with the peritoneal cavity.
- Excessive production of fluid within the scrotal sac.
- Defective absorption of fluid.
- Abnormalities in the lymphatic drainage of scrotal structures, this mainly occurs due to any kind of Infection or inflammation.
3. Investigations :
- Coughing impulse : Expansile impulse on coughing is absent
- Mobility : This shows the testes mobile from side to side.
- Transillumination : Test is positive.
- Traction test : The swelling’s ability to move is restricted when there is friction on the testis.
- Fluctuation test : Swelling is soft cystic in feel and fluctuation test shows positive.
- Ct Scan : This is ultimate option to diagnose Hydrocele.
4. Treatment :
- Congenital hydrocele mainly treated by Herniotomy.
- Acquired hydrocele : These are treated by Plication, Eversion, Excision.