What Is a Hydrocele?
The testicles, which are male reproductive organs shaped like eggs that create sperm, have thin skin or capsules around them that fill with fluid. This causes swelling in the scrotum, which is a loose bag of skin that contains the two testicles in men. A hydrocele is the term for this swelling. In general, hydroceles are painless and harmless.
Who Is Affected by Hydrocele?
Males are more likely to get hydrocele; it usually affects newborns, but it can also strike older boys and adult men. Approximately 10 % of newborn boys are born with hydroceles, which often go away by the time they are a year old and need not be treated. In elderly males, hydroceles most frequently occur as a result of inflammation or trauma.
How Does a Hydrocele Develop?
Hydroceles develop through one of four mechanisms:
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Congenital: A patent processus vaginalis connects the hydrocele to the peritoneal cavity. The stomach, spleen, liver, and small intestine are among the organs that are housed in the fluid-filled peritoneum. Throughout the child's growth and development in the mother's womb, the testes travel down a tunnel called the processus vaginalis towards the scrotum. The peritoneum and scrotum may begin to communicate when there is an open or patent processus vaginalis. This causes scrotal enlargement and fluid accumulation, which leads to the development of a hydrocele.
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Overproduction of Fluids: This condition is referred to as a secondary hydrocele.
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Improper absorption of fluids.
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Interference with lymphatic drainage inside the scrotal tissues.
A hydrocele may arise from scrotal injury or inflammation (resulting from testicular or epididymal infection).
While hydrocele typically develops congenitally in children, filariasis is the main cause in adults. The parasitic worm Wuchereria bancrofti is the cause of filariasis.
What Are the Different Types of Hydroceles?
Hydroceles can fall under any of the following categories:
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Primary Hydrocele: A hydrocele forms in the scrotum as a result of fluid buildup brought on by the patent processus vaginalis.
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Secondary Communicating Hydrocele: The scrotal sac does not close. If it is compressed, it could swell up and start to leak fluid into the abdomen. One common issue with communicating hydroceles is an inguinal hernia.
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Secondary Non-communicating Hydrocele: The sac closes, but the fluid remains, and by the end of the first year of life, it has been absorbed.
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Microbe-Induced Hydrocele: Occurs as a result of several different microbiological origins, including tuberculous hydrocele, syphilitic hydrocele, parasitic hydrocele, and elephantiasis hydrocele.
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Inflammatory Hydrocele: Caused by an inflammation in the scrotal area.
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Iatrogenic Hydrocele: Developed as a result of medical mistakes made during operations like the placement of a penile prosthesis or the movement of a penile prosthesis pump.
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Trauma-Induced Hydrocele: Caused by significant trauma to the penile or scrotal regions, which injures and swells the scrotal sac.
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Tumor-Induced Hydrocele: Tumors of the testis, spermatic cord, and epididymis may result in hydrocele formation.
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Canal of Nuck: The canal of Nuck hydrocele is also known as the cyst of the canal of Nuck or the female hydrocele. When a girl's processus vaginalis fails to close during her growth in the womb, she may develop a rare hydrocele. Hydrocele development and inguinal hernia result from this.
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Giant Hydrocele: Hydroceles that are larger than the patient's head or whose contents exceed 1000 milliliters are referred to as giant hydroceles.
What Are the Risk Factors for Developing Hydrocele?
1. Children:
- Usually, hydroceles are present from birth. Five to ten percent of newborn boys are born with hydrocele.
- A hydrocele may be more likely to develop in premature newborns.
2. Adults:
- Scrotal injury.
- Scrotal inflammation.
- Infections including sexually transmitted infections (STIs).
What Are the Signs and Symptoms of Hydrocele?
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The most common symptom is a painless swelling in one or both testicles.
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For adult males, the scrotal enlargement and heaviness linked to hydroceles can be a little uncomfortable.
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Additionally, the patient could feel pain that gets worse as the hydrocele gets bigger.
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A lesser swelling in the morning and a larger swelling later in the day are possible variations in the swelling's size.
When Should One Seek Medical Help?
Hydrocele in babies usually resolves on its own. Request that the child's pediatrician examine the hydrocele again if it persists in your child following a year or if the swelling worsens.
If the child experiences sudden, excruciating pain or swelling in the scrotum, get medical attention right soon. If the pain or swelling appears within a few hours following a scrotal injury, it is vital to seek care right away. Certain medical conditions, such as twisted testicles with limited blood flow, can cause these symptoms. Testicular torsion is the term for this issue. To preserve the testicle, treatment must be administered within hours of the onset of symptoms.
What Are the Complications of Hydroceles?
Although a hydrocele by itself does not pose a risk to fertility, it may be a sign of underlying testicular problems that could lead to complications:
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Infection: Reduced sperm function and production may result from infection.
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Tumor: This may impair the function and generation of sperm.
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Inguinal Hernia: Serious consequences might arise from an inguinal hernia.
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Hematocele: Bleeding or aggregation of blood in the scrotal sac.
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Pyocele: A buildup of pus-filled fluid around the testicles in the scrotal sac. It is composed of debris, locations (a localized swollen mass resulting from inadequate fluid outflow), and septations (partitions dividing the cavity into compartments).
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Testicular Atrophy: Testicular atrophy is the shrinkage of the testicles, frequently along with their lack of functionality.
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Infertility.
How Is Hydrocele Diagnosed?
1. Physical Examination: The first step to diagnosis is a physical exam that involves:
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Tenderness: Examining the scrotum for tenderness.
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Inguinal Hernia: To check for an inguinal hernia, pressure is administered to the scrotum and abdomen.
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Transillumination: This technique entails beaming light via the vagina. Clear fluid will be evident in the area around the testicle if there is a hydrocele.
2. Laboratory Examination: Following the physical exam, the doctor may advise laboratory tests that include:
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Ultrasound: Testicular tumors and hernias are two more potential causes of scrotal edema that can be ruled out with the use of an ultrasound.
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Blood and Urine Tests: These can aid in the diagnosis of infections that include epididymitis.
How Is Hydrocele Treated?
Babies:
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Typically, hydroceles vanish within a year of life. However, one needs to see a doctor if a hydrocele has not only gotten more noticeable but has also not disappeared.
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Any age-related development of hydroceles must be evaluated by medical professionals in order to accurately diagnose and rule out other testicular problems.
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Surgery can be required if a hydrocele does not go away on its own after a year.
Adults:
The typical lifespan of a hydrocele is only six months. Surgery is only necessary in cases where the hydrocele is bothersome or communicative, as these conditions can result in hernias.
The procedures that may be performed in the treatment of hydrocele include:
1. Surgery:
A hydrocelectomy is a surgical technique that is carried out under local or general anesthesia. It is accomplished by cutting a hole in the lower abdomen or scrotum, after which the hydrocele is removed. The area might receive a thick dressing, and occasionally a drainage tube might be needed for a while. The procedure may carry a few risks, including:
- Injury to the scrotum (including nerve damage).
- Uncontrolled bleeding.
- Infections.
2. Needle Aspiration:
This technique may be chosen when surgery may present a risk to the patient. The fluid is extracted from the scrotal sac using a long needle.
Side effects may include:
- Infection risk (possibility of contracting an infection).
- Transient pain in the scrotum.
3. Aspiration and Sclerotherapy:
A large needle is used to extract the fluid from the scrotal sac first. Subsequently, a solution is injected into the veins, resulting in scarring and facilitating blood flow.
What Kind of Outcomes Can One Anticipate if Having This Condition?
A hydrocele usually has a very good prognosis. The majority of instances resolve on their own, and the success rate for cases requiring surgery is great.
How Can Hydroceles Be Prevented?
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Newborn Babies: Hydroceles in newborn boys cannot be avoided because they occur during the developmental stage in the mother's womb.
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Adolescent Boys and Adult Men: Try to keep the scrotal and testicular regions as safe as possible.
Although hydroceles may not pose a serious risk, scrotal swellings and anomalies should be reported to physicians. This guarantees that the swelling is accurately diagnosed if it is caused by another condition.
Conclusion:
Hydroceles are frequently seen in infant boys. Even if they are upsetting, there is no need to panic because they go away quickly. In adults, they are similarly innocuous unless related issues develop. Seeking the advice of a urologist can alleviate physical and psychological symptoms and help establish whether therapy is necessary.
