HYDROCELE

Question 1

Definition

Answer 1

It is the collection of fluid between the two layers of tunica vaginalis of testis.

Question 2

Pathophysiology

Answer 2

🌚Communicating hydroceles:
processus vaginalis fails to close with small opening for fluid to move freely between peritoneal cavity through patent processus (if opening progresses to allow passage of intestine, it is a hernia)

🌚Noncommunicating hydroceles:
fluid trapped in tunica vaginalis; in older children, may be secondary to testicular pathology (reactive hydrocele)

Question 3

Clinical Features

Answer 3

🌚 Painless scrotal mass Communicating hydroceles increase in size with standing or valsalva, may be absent in the morning and large in the evening
🌝 Transillumination suggests hydrocele Silk glove sign: gently palpating hydrocele sac over pubic tubercle feels like rubbing silk on silk

Question 4

Investigations

Answer 4

U/S if suspect pathology

Question 5

Treatment

Answer 5

Most resolve spontaneously by 1 yr

🌚Surgical repair if:
Persistence >2 yr
 Pain
 Fluctuating in size which suggests communication 
Cosmetic reasons
 Infection