A hydrocele is a collection of fluid within the tunica vaginalis of the testis that results from an imbalance between the production and absorption of fluid in the sac. It can cause symptoms like a feeling of heaviness or fullness in the scrotum. A hydrocele is diagnosed by physical examination finding a fluid-filled sac that transilluminates and fluctuates. Treatment options include surgery to remove the sac (hydrocelectomy) or aspiration and injection of a sclerosing agent into the sac.

1. HYDROCELE
DR SHIV CHARAN NAVRIYA
ASSISTANT PROFESSOR
DEPARTMENT OF UROLOGY
AIIMS RISHIKESH

4. HYDROCELE
 Defined as a collection of fluid within the tunica vaginalis of the testis.

5.  Premature - 44%
 Full term – 4-5%
 Disturbed Balance between produced and absorbed fluid
 Heaviness, fullness, dragging sensation , cosmetic problem, radiating pain to back

6. Pathophysiology
 Excessive production of fluid within sac
 Defective absorption of fluid
 Interference with lymphatic drainage
 Connection with peritoneal cavity via patent processus vaginalis

7. Imbalance between the fluid secretion and absorption of the tunica vaginalis

26. DIFFERENTIAL DIAGNOSIS: SCROTAL CYSTIC
MASSES
 Indirect inguinal hernia
 Epididymis cyst
 Hydrocele
 Varicocele
 Spermatocele
 Pyocoele
 Hematocele

27. DIFFERENTIATION
Palpate cord above
mass
YES NO
Transillumination YES NO
Fluctuate YES NO
Fluid thrill YES NO

28. DIFFERENTIATION
Testis palpable NO YES
Cough impulse NO YES
Reducible NO YES
Bowl sounds NO YES

30. TREATMENT
 Communicating
 Tying off the patent processus vaginalis
 Primary
 Hydrocelectomy
 Aspiration + injection of sclerosing agent
 Secondary
 Treat underlying pathology