Hydrocele: Symptoms, Diagnosis, and Treatment Insights

The testicle is covered by several layers that protect it:

• Tunica albuginea, the innermost, from which the fibrous tracts that compartmentalize the gonad emerge.
• Vaginal tunic, a serous one that covers it with two layers, the vaginal and the parietal.
• Internal spermatic fascia, made of fibrous tissue.
• Cremaster muscle, which is responsible for retracting the testicle.
• External spermatic fascia, also made of fibrous tissue.
• Subcutaneous tissue.
• Dartos muscle, a very thin muscle attached to the scrotum that retracts it and thus helps regulate scrotal temperature.
• Scrotum, layer of skin that surrounds the rest of the scrotal structures.

When for various reasons fluid accumulates between the two layers of the vaginal tunic, producing a, it is said that the patient suffers from a hydrocele.

How is it produced?

Hydrocele is a benign accumulation of fluid in the scrotal sac. Sometimes it also occurs around the spermatic duct. It can develop acutely secondary to testicular trauma, radiation therapy, orchitis, tuberculous epididymitis, or testicular neoplasia. Chronic hydrocele is more common and usually affects men over 40 years of age.

The congenital communicating hydrocele, typical of newborns and children, is due to the fact that the vaginal tunic is permeable and communicates with the peritoneal cavity through the peritoneovaginal canal, which has not been adequately closed.

Symptoms

The main symptom of hydrocele is scrotum enlargement. It does not cause pain and at most, if it is large, it can cause discomfort when rubbing with the thighs.

Diagnosis

The diagnosis is based on the physical exploration, in which an enlarged scrotum with a liquid consistency inside will be palpated. Applying a light source to the scrotum will pass it through. The scrotum should be properly explored to rule out infection, or a possible hernia.

The scrotal ultrasound it will allow to carry out the diagnosis of certainty.

Treatment

Congenital hydroceles usually resolve on their own before one year of age; beyond that age, closure is unlikely.

The definitive treatment of hydrocele is surgical. In children, the communication process between the peritoneum and the vaginal tunic is closed, while in adults, an eversion of the vaginal tunic is performed after draining the fluid and the edges of the tunic are sutured to prevent it from reproducing.

Another therapeutic option is aspirate the fluid through a puncture and then instill a sclerosing substance that joins both layers of the vaginal tunic. It is a less aggressive technique, but it recurs more frequently.

Precautionary measures

They do not exist risk factor's for this disease, so there are no specific preventive measures to avoid it.