From the Guidelines
Hydrocele is generally considered a benign condition. According to the American College of Radiology's 2024 update on acute onset of scrotal pain, hydrocele is listed as one of the diagnostic considerations for acute scrotum, but it is not typically associated with the urgent need for surgical intervention seen in conditions like testicular torsion 1. The condition occurs when fluid collects in the thin sheath surrounding a testicle, causing swelling in the scrotum. Key characteristics of hydroceles include:
- They are common and typically painless
- They may cause discomfort due to their size
- Most hydroceles don't require treatment unless they become large or uncomfortable
- For bothersome hydroceles, surgical correction (hydrocelectomy) is the definitive treatment, which can be performed as an outpatient procedure under local or general anesthesia 1. It's crucial to have any scrotal swelling evaluated by a healthcare provider to rule out more serious conditions like testicular cancer, as the differential diagnoses for acute scrotum are numerous and include potentially life-threatening conditions 1.
From the Research
Definition and Classification of Hydrocele
- A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma 2.
- Hydroceles can be divided into two types: primary and secondary, and can be further classified into different categories, including microbe-induced, inflammatory, iatrogenic, trauma-induced, tumor-induced, canal of Nuck, congenital, and giant 2, 3.
Etiology and Clinical Manifestations
- Hydroceles result from an imbalance of secretion and reabsorption of fluid from the tunica vaginalis 3.
- Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy 3.
- Hydroceles can cause discomfort and psychosocial distress, and can be associated with sexual dysfunction in the aging male 4.
Treatment Options
- Hydroceles can be managed by conservative treatment, fluid aspiration, or hydrocelectomy 3.
- Aspiration and sclerotherapy is a safe and effective treatment alternative for hydrocele, with success rates ranging from 76% to 94% 5, 4, 6.
- Sclerosing agents such as doxycycline and sodium tetradecyl sulphate (STDS) can be used for aspiration and sclerotherapy, with STDS having the best cure rate after a single injection and low side effect rates 4.
Benign Nature of Hydrocele
- Hydrocele is generally considered a benign condition, with treatment options available to manage symptoms and prevent complications 2, 3, 5, 4, 6.
- While hydroceles can cause discomfort and distress, they are not typically life-threatening and can be effectively treated with conservative or surgical methods 2, 3, 5, 4, 6.