Can benign prostatic hyperplasia (BPH) cause hydrocele?

From the Guidelines

Benign prostatic hyperplasia (BPH) does not directly cause hydrocele, as these are two distinct conditions with unrelated pathophysiologies. BPH involves the non-cancerous enlargement of the prostate gland, which surrounds the urethra and can cause urinary symptoms like frequent urination, weak stream, and incomplete bladder emptying 1. Hydrocele, on the other hand, is a collection of fluid in the scrotum around the testicle, resulting in scrotal swelling. The development of BPH is attributed to hormonal changes and aging that affect prostate tissue growth, whereas hydrocele forms due to imbalances in fluid production and absorption within the tunica vaginalis surrounding the testicle.

Key Differences and Considerations

• BPH and hydrocele have different causes, symptoms, and treatments, indicating that they should be evaluated and managed separately.
• The presence of one condition does not directly influence the development of the other, although both can occur in older men.
• Treatment for BPH, such as the use of 5-alpha-reductase inhibitors like finasteride, is aimed at reducing prostate size, improving urinary flow, and alleviating symptoms 1, but it does not address the pathophysiology of hydrocele.
• Hydrocele management may involve observation, aspiration, or surgical intervention, depending on the severity and impact of the condition on the patient's quality of life.

Clinical Implications

Given the distinct nature of these conditions, it is crucial to evaluate scrotal swelling separately from prostate issues, as it likely represents a distinct condition requiring its own specific management approach. This ensures that each condition is appropriately diagnosed and treated, optimizing patient outcomes in terms of morbidity, mortality, and quality of life.

From the Research

Benign Prostatic Hyperplasia and Hydrocele

• Benign prostatic hyperplasia (BPH) is a condition characterized by an enlarged prostate, lower urinary tract symptoms (LUTS), and a decreased urinary flow rate 2.
• The available evidence does not directly address the relationship between BPH and hydrocele, which is an accumulation of fluid in the tunica vaginalis, a potential space around the testicle 3, 4, 5, 6.
• BPH is primarily associated with lower urinary tract symptoms, such as difficulty urinating, frequent urination, and weak urine flow, rather than directly causing hydrocele 2, 3, 4, 5, 6.
• The pathophysiology of BPH involves the androgen system, prostatic inflammation, and metabolic parameters, but there is no clear link to hydrocele 6.
• Treatment options for BPH include 5-alpha reductase inhibitors, alpha-adrenergic antagonists, and combination therapy, but these do not address hydrocele directly 2, 3, 4, 5.

Key Findings

• BPH is a progressive disease that can lead to complications such as acute urinary retention and the need for surgery 2.
• Combination therapy using alpha-1 adrenergic receptor antagonists and 5-alpha reductase inhibitors is effective in managing BPH-related symptoms and preventing disease progression 3, 4.
• The pathophysiology of BPH is complex and involves multiple factors, including the androgen system, prostatic inflammation, and metabolic parameters 6.

Treatment and Management

• Treatment options for BPH focus on relieving symptoms and preventing disease progression, but do not directly address hydrocele 2, 3, 4, 5.
• Combination therapy and medical treatments are available for managing BPH, but their effectiveness in preventing or treating hydrocele is not established 3, 4, 5.