Hydrocele
What is a hydrocele?
A hydrocele is a collection of watery fluid around the testicle.
Why does it happen?

This is a common problem in newborn males and usually goes away within the first year of life. When the testicle drops into the scrotum (about the eighth month of pregnancy), a sac (the processus vaginalis) from the abdominal cavity travels along with the testicle. Fluid can then flow to the scrotum to surround the testicle. This sac usually closes and the fluid is absorbed.

 
What are the types of hydrocele?

When the sac closes and the fluid remains, this is called a noncommunicating hydrocele. This means that the scrotal sac can be compressed and the fluid will not flow back into the abdomen. This type of hydrocele is often found in newborns and the fluid will usually be absorbed with time. If the scrotal sac is compressed and the fluid slowly goes back up into the abdomen or if the hydrocele changes size, this is called a communicating hydrocele. This type of hydrocele usually appears smaller in the morning when the child wakes up and larger in the evening after activity. A communicating hydrocele shows that the sac or processus vaginalis is still open.

 

normal scrotum

non-communicating hydrocele

communicating hydrocele

Normal scrotum:
the processus vaginalis and tunica vaginalis are obliterated and contain no fluid.

Noncommunicating hydrocele:
the processus vaginalis is obliterated so no fluid can move between the abdomen and the scrotum, but the tunica vaginalis contains fluid.

Communicating hydrocele:
the processus vaginalis is still open, allowing fluid to move between the abdomen and the tunica vaginalis in the scrotum.

When is surgery recommended for hydroceles?
Surgery is recommended if the hydrocele is still present after 18 months- 2 years of age. Hydroceles that continue to get larger are symptomatic and should be fixed.
What Surgery is done for hydroceles?
The surgery for hydroceles is same as that for hernia.
 
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