Skip to content

Hydrocele – Clinical features | Pathophysiology | Investigations | Treatment

  • by


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 :

  1. The swelling is usually painless.
  2. If the testis is gently tugged downward, the enlargement moves downward and becomes less mobile.

2. Pathophysiology :

Hydrocele mainly occurs by four different mechanism :

  1. Patent processus vaginalis gets connected with the peritoneal cavity.
  2. Excessive production of fluid within the scrotal sac.
  3. Defective absorption of fluid.
  4. Abnormalities in the lymphatic drainage of scrotal structures, this mainly occurs due to any kind of Infection or inflammation.

3. Investigations :

  1. Coughing impulse : Expansile impulse on coughing is absent
  2. Mobility : This shows the testes mobile from side to side.
  3. Transillumination : Test is positive.
  4. Traction test : The swelling’s ability to move is restricted when there is friction on the testis.
  5. Fluctuation test : Swelling is soft cystic in feel and fluctuation test shows positive.
  6. Ct Scan : This is ultimate option to diagnose Hydrocele.

4. Treatment :

  1. Congenital hydrocele mainly treated by Herniotomy.
  2. Acquired hydrocele : These are treated by Plication, Eversion, Excision.