Hydrocele
Basics
Description
Description
- Most common cause of painless scrotal swelling
- Classified as congenital or acquired (secondary):
- Congenital result from a patent process vaginalis and communication between tunica vaginalis and peritoneal cavity:
- Normally occurs spontaneously and most are closed by 2 yr of age
- Acquired occur secondary to interscrotal infection, neoplasm, inguinal or scrotal surgery, or regional or systemic disease
- Congenital result from a patent process vaginalis and communication between tunica vaginalis and peritoneal cavity:
- Communicating hydrocele:
- Patent processus vaginalis
- Scrotum fills and empties with peritoneal fluid depending on body position and intraperitoneal pressures
- Noncommunicating hydrocele:
- Due to production of serous fluid by a disease process or impaired absorption within the scrotum itself
Etiology
Etiology
- Imbalance between production and resorption of fluid within the space between tunica vaginalis and tunica albuginea
- Disease processes causing adult noncommunicating hydrocele include:
- Epididymitis
- Hypoalbuminemia
- TB
- Trauma
- Mumps
- Spermatic vein ligation
- In developing world, hydrocele is primarily caused by infections such as Wuchereria bancrofti or Loa Loa (filariasis is the cause of most hydroceles worldwide)
- Rarely malignancy (first-degree testicular neoplasm or lymphoma)
- Rare etiology is the abdominoscrotal hydrocele that may cause hydroureter or unilateral limb edema owing to compression:
- US reveals single sac extending from scrotum into abdominal cavity via the deep inguinal ring
Pediatric Considerations
- Congenital in 6% of newborn boys
- Usually diagnosed in newborn nursery
- Caused by patent processus vaginalis, a structure that remains patent in 85% of newborns
- May vary in size owing to position or crying:
- Patients may present with history of scrotal mass that has resolved
- Most close by the age of 2 yr
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Citation
Schaider, Jeffrey J., et al., editors. "Hydrocele." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307183/all/Hydrocele.
Hydrocele. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307183/all/Hydrocele. Accessed December 1, 2024.
Hydrocele. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307183/all/Hydrocele
Hydrocele [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307183/all/Hydrocele.
* Article titles in AMA citation format should be in sentence-case
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T1 - Hydrocele
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ED - Barkin,Adam Z,
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ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307183/all/Hydrocele
PB - Lippincott Williams & Wilkins
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DB - Emergency Central
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