Hydrocele

Definition:

The accumulation of serous fluid in the processus vaginalis (tunica vaginalis) is called Hydrocele.

Types of Hydrocele:

A.    Congenital:

When the fluid accumulate between the tunica vaginalis and processus vaginalis and it communicates with the peritoneal cavity.

B.    Acquired:

1.     Primary Hydrocele:

a.      Vaginal:

When the fluid accumulates in tunica vaginalis is called vaginal Hydrocele.

b.     Infantile:

When the fluid accumulates in tunica vaginalis and processus vaginalis but it does not communicate with peritoneal cavity is called infantile Hydrocele.

c.      Encysted:

When the fluid accumulates in some part of processus vaginalis is called encysted Hydrocele.

d.     Funicular:

When the fluid is only in processus vaginalis is called funicular Hydrocele.

2.     Secondary Hydrocele:

It can occur due to:

·         Trauma

·         Tumor

·         Infection (epidydimo-orchitis)

Clinical features of Hydrocele:

         i.            Swelling of scrotum

       ii.            The swelling is translucent

      iii.            In vaginal type the swelling is limited to scrotum. In congenital type one can’t go above the swelling. In infantile type the swelling ends in inguinal canal and one can go above the swelling.

     iv.            The rugosity on skin is lost.

Management:

         i.            Aspiration of fluid is done through a cannula.

       ii.            Sclerosing agent (tetracyclins) can be introduced into tunica to prevent reaccumulation.

Surgery:

a)     Lord’s plication/ Jabuly’s procedure:

The tunica vaginalis is everted and sutures are applied.

b)     Subtotal excision:

Subtotal excision of tunica vaginalis is an option.