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hydrocele
A fluid-filled sack along the spermatic cord within the scrotum.
Etiology:
- failure of the testicular tract from the abdomen into the scrotum to close during development
- testicular inflammation or injury
- epididymitis
- blockage within the spermatic cord
- may be associated with inguinal hernia
Epidemiology:
- common in newborn infants
Pathology:
- during development, the testes descend from the abdomen into the scrotum
- when the tract of the testes fails to close, fluid may drain from the abdomen into the scrotum
- thus drainage of abdominal fluid into the scrotum results in a swollen scrotum
- fluid collection between the layers of the tunica vaginalis [2]
Clinical manifestations:
1) painless, swollen scrotum (may be painful [2]]
2) unilateral or bilateral
3) transillumination through fluid filled scrotum
Special laboratory:
- ultrasound
Management:
1) congenital hydroceles generally resolve within a few months
2) transillumination
a) if mass transilluminates
1] it is either a hydrocele or spermatocele
2] generally asymptomatic
3] may cause discomfort if large
4] surgical excision
5] aspiration not useful because of recurrence
6] ultrasound not necessary
b) if mass does not transilluminate
1] ultrasound of mass
2] referral to urology
3) asymptomatic transilluminating hydroceles generally do not require treatment
4) pain control as needed
Related
scrotal pain/mass (testicular pain, testicular torsion)
varicocele; cirsocele; pampinocele
General
abnormal morphologic structure (malformation)
male genital disease
References
- V Altebarmakian, Kaiser Permanente, Fresno CA, 1/2000
- Medical Knowledge Self Assessment Program (MKSAP) 16, 18.
American College of Physicians, Philadelphia 2012, 2018.
- PubMed Health: Hydrocele
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001546/