Hydrocele
Hydrocele is caused by an abnormal accumulation of fluid between the two layers that make up the vaginal tunic surrounding the testicle. It is a physical condition that, although not very serious, could negatively affect the patient’s relationships.
It may occur for several reasons.
In newborns, it is often a congenital disorder due to the failure of the vaginal process to close, which allows the passage of intraperitoneal fluid to the scrotum.
In adults, however, it is referred to as reactive or secondary hydrocele, generally due to inflammation of the testis or epididymis or to trauma.
There are also cases of idiopathic hydrocele, where no specific cause can be identified.
SYMPTOMS
The collection of fluids between the parietal and visceral layers of the tunica vaginalis causes a painless swelling. The increase in the scrotal volume can be highly variable and can also change throughout the day. The scrotal consistency can be soft or tense.
Although it usually does not lead to significant complications, in more severe cases it can result in an alteration of testicular development, with possible repercussions on fertility as well. Therefore, it is always advisable not to underestimate the condition.
DIAGNOSIS AND TREATMENT
The diagnosis is based on the physical examination and scrotal ultrasound, a decisive test in the evaluation of scrotal masses, which is completely noninvasive and harmless.
Regarding the management, there are two main options:
- Conservative management
- Surgical treatment
In newborns, observation is highly recommended before considering surgical treatment, as in most cases, the hydrocele spontaneously resolves within the first 12 months of life. However, the rate of spontaneous resolution dramatically decreases after the first year, and if the condition persists, surgery is strongly indicated.
For adults, the therapeutic choice depends on the symptoms. A hydrocele with irrelevant symptoms does not require any specific therapy. In more significant cases, surgery is recommended. The surgical procedure, which involves resection or eversion of the vaginalis, is minimally invasive ensuring an invisible scar.
Although hydrocele is generally considered a benign condition, you should not overlook the stress that it can generate in the patient. It can indeed cause physical discomfort and aesthetic concerns in men, leading to feelings of embarrassment and insecurity. That is why it is always essential to provide the patient with the appropriate emotional support.
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