Complications[ edit ] Rupture usually occurs as a result of trauma but may be spontaneous. On rare occasions cure results after the fluid has been absorbed. Transformation into a haematocele occurs if there is spontaneous bleeding into the sac or as a result of trauma. Acute haemorrhage into the tunica vaginalis sometimes results from testicular trauma and it may be difficult without exploration to decide whether the testis has been ruptured.
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It is smooth, and is mainly in front of the testis. Hydroceles vary greatly in size and are typically painless and harmless. However, as the fluid continues to accumulate and the scrotum further enlarges, more discomfort can be expected. Large hydroceles will cause discomfort because of their size. Sometimes pain can be in both testicles as pressure from the enlarged area puts pressure against the unaffected area which can cause discomfort to the normal testicle.
As the fluid of a hydrocele is transparent, light shone through the hydrocelic region will be visible from the other side. This phenomenon is called transillumination. Symptoms of a hydrocele can easily be distinguished from testicular cancer , as a hydrocele is soft and fluid-filled, whereas testicular cancer feels hard and rough. Fertility[ edit ] A hydrocele testis is not generally thought to affect fertility. However, it may be indicative of other factors that may affect fertility.
This peritoneal tissue is known as the processus vaginalis. Normally, the communication between the processus vaginalis and the peritoneum is obliterated, and the tunica vaginalis is the tissue that remains overlying the testis and the epididymis. Congenital hydrocele results when the processus vaginalis remains, allowing fluid from the peritoneum to accumulate in the scrotum.
Scrotal ultrasound of a 1 dm large hydrocele, with anechoic dark fluid surrounding the testicle. Communicating hydrocele, caused by the failure of the processus vaginalis closure. Through diagnostic ultrasound the accumulation of fluids can be diagnosed correctly. Treatment[ edit ] The fluid accumulation can be drained by aspiration , but this may be only temporary. A more permanent alternative is a surgical procedure, generally, an outpatient ambulatory same-day procedure, called a hydrocelectomy.
There are two surgical techniques available for hydrocelectomy. Hydrocelectomy with Excision of the Hydrocele Sac Incision of the hydrocele sac after complete mobilization of the hydrocele.
Care is taken not to injure testicular vessels, epididymis or ductus deferens. Hydrocele surgery with excision of the hydrocele sac is useful for large or thick-walled hydroceles and multilocular hydroceles.
Hydrocele Surgery with Plication of the Hydrocele Sac The hydrocele is opened with a small skin incision without further preparation. The plication technique is suitable for medium-sized and thin-walled hydroceles.
The advantage of the plication technique is the minimized dissection with a reduced complication rate. The hydrocele fluid can be aspirated. J Urol. The Journal of Urology.
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