From the Guidelines
Hydroceles are commonly associated with several medical conditions, including epididymitis, orchitis, and sexually transmitted infections, as well as congenital defects, trauma, inflammation, or tumors, as noted in the most recent study 1.
Medical Conditions Associated with Hydroceles
Hydroceles can be caused by a variety of medical conditions, including:
- Infectious causes: epididymitis, orchitis, and sexually transmitted infections, as mentioned in 1 and 1
- Inflammatory conditions: vasculitis or autoimmune disorders, which can trigger hydrocele formation
- Trauma: reactive fluid accumulation due to scrotal trauma
- Testicular tumors: can produce hydroceles as a secondary effect
- Filariasis: a parasitic infection caused by Wuchereria bancrofti, significant in endemic regions
- Systemic conditions: cirrhosis, nephrotic syndrome, or heart failure, which can contribute to hydrocele formation through fluid imbalances
Diagnostic Considerations
The evaluation of men for epididymitis, as mentioned in 1 and 1, should include procedures to diagnose hydroceles, and the use of ultrasound, as noted in 1 and 1, can be helpful in differentiating between epididymitis and testicular torsion.
Treatment Options
Most hydroceles are benign and may resolve spontaneously, but persistent or symptomatic cases may require surgical intervention through hydrocelectomy or needle aspiration, especially when associated with underlying pathology, as mentioned in the example answers.
Recent Guidelines
The most recent study 1 provides updated guidelines for the evaluation and management of scrotal pain, including the use of ultrasound to diagnose hydroceles and other scrotal disorders.
From the Research
Medical Conditions Associated with Hydroceles
- Hydroceles are generally asymptomatic and are managed supportively 2
- They can be associated with reduced fertility, as seen in varicoceles, although it is uncertain if surgical or radiologic treatment of varicoceles in subfertile men improves the rate of live births 2
- Hydroceles are a type of painless scrotal mass, which also includes varicoceles and testicular cancer 2, 3
- Epididymitis, which is usually caused by infection with Chlamydia trachomatis, Neisseria gonorrhoeae, or enteric bacteria, can be associated with hydroceles as both are scrotal conditions 2, 3
- Testicular torsion, a urologic emergency, can be differentiated from hydroceles as it is a painful condition 2, 3
Classification and Diagnosis of Hydroceles
- Hydroceles can be divided into two types: primary and secondary 4
- The diagnosis of hydroceles should be based on medical history, clinical manifestations, and imaging studies 4
- Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy 4