Hydrocele Accumulation of fluid in the scrotum

Hydrocele is a benign pathological condition, characterized by the accumulation of fluid between the two leaflets of the testicular vaginal tunica, resulting in an increase in the volume of the hemiscrotum.

Pathophysiology is established when there is an imbalance between the production (which can increase) and reabsorption (tends to decrease) of the fluid that lubricates the tunics that surround each testicle.

Possible causes may be congenital (eg, persistence of the peritoneo-vaginal canal) or acquired (infections, trauma, tumors or previous inguino-scrotal post-surgery).

It can then be classified into Congenital Hydrocele (occurs in pediatric age) or Acquired Hydrocele (more common in adults).

However, in most cases, the etiology is idiopathic, unknown.

The most common symptoms are an increase in the volume of the hemiscrotum, scrotal discomfort and sometimes episodes of pain and inflammatory signs, such as heat and flushing.

An objective sign, in addition to the swelling and palpation, which is generally painless, is the transillumination test of the scrotum that suggests the presence of liquid content.

The differential diagnosis is made with inguino-scrotal hernias, tumors of the testis, infectious pathology of the scrotum or other benign lesions.

The complementary diagnostic test indicated is scrotal ultrasound, which allows the hydrocele (liquid content) to be identified and the testis, sperm cord and other structures to be evaluated.

The indication for surgical treatment occurs when the volume of the scrotum is the cause of discomfort, chronic pain, limitations on urination or sexual activity, and for aesthetic reasons.