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Hydrocele

Hydrocele – Causes, Diagnosis and its Treatment

 

Introduction

Hydrocele is a fairly painless medical condition in which watery fluid gets collected around either or both the testicles thereby causing the scrotum or the groin area to swell. This buildup of liquid is rarely dangerous and can be unsightly.

Sometimes a young female or a woman may also experience hydrocele due to the common embryological background of males and females. While in case of a male it is the scrotum area that swells up, in women the same situation arises in the labia majora (the outermost labial structure).

There are not many varied symptoms of hydrocele. Generally, the only sole indication of the condition is painless swelling of one or both testicles. However, some males, especially adults, may feel discomfort due to the heaviness of the swollen scrotum. In some men the scrotum may become smaller in night in comparison to daytime.

Causes

The exact cause behind the development of hydrocele is not scientifically known. Sometimes hydrocele develops due to a general swelling of the testicular sac on the account of fluid retention.  In a less likely situation hydrocele may develop due to some medical problem pertaining to either of the testes. This problem could be any of these- injury, infection, inflammation, or tumors.  Any of these could lead to the fluid formation which in turn gives rise to hydrocele.

Risk Factors

Radiation therapy, which is used for the treatment of prostate cancer, and scrotal injury can increase the risk of developing hydroceles. Age can also be a contributing risk factor, since men aged 40 or more have higher probability of getting hydroceles. Sometimes, an infection, especially through STDs can also lead to the development of hydroceles.

Diagnosis

The diagnosis of hydrocele is generally done clinically, wherein a doctor feels the testes for swelling. A simple analogy to show the physical appearance of hydrocele can be a small water balloon containing a small walnut. Furthermore, the differences between communicating hydrocele and non-communicating hydrocele help to support the suspected diagnosis.

Communicating Hydrocele- Before birth the testicles are developed in the child’s abdomen, and just a few weeks before birth they move connected to the tube (called processus vaginalis) to the scrotum. When this happens the tube is closed. However, in a rare case when the tube doesn’t close the abdominal fluid can get collected in the scrotum, which causes communicating hydrocele.

Non-communicating Hydrocele- In this condition the fluid remains in a closed sac and is not absorbed by the body over a period of time. Men aged 40 or more are at a higher risk of developing non-communicating hydrocele due to an injury or infection in the scrotal area.

Complications

While hydrocele itself is pretty much a harmless condition, and is benign in nature, it can sometimes be a sign of a more critical testicular disease such as infection or tumor. In case infection occurs in the tests then it could lead to a surgical intervention, and hence no matter the symptoms and discomfort, hydrocele should be taken seriously.

Other common complications of hydrocele include blood clots and injury to the scrotal area.

Prevention

Since hydroceles develops in a male before he is born, it is not possible to prevent the condition in newborn infants. However, by maintaining good prenatal care premature births can be prevented, which will in turn reduce the risks of developing hydroceles.

Adult males can take extra care not to injure their genitals (which is a common cause behind hydroceles attainment). For instance, a man can wear protective cup over his genitals so as not to injure himself while playing a sport.

Treatment for Hydrocele

While most hydroceles don’t require treatment since they tend to resolve by themselves without any medical aid, sometimes when a patient experiences high discomfort or the scrotum becomes excessively large, then a proper treatment is necessary. There are mainly two kinds of hydrocele treatments-

Aspiration– While aspiration is not a generally preferred treatment a doctor may go with it in case surgery is too risky. In this a needle is used to drain the fluid out of the scrotum, followed by the injection of medication to prevent hydrocele from recurring and to close the sac. However, there are certain risks that come along with aspiration. These include fibrosis, in which tissues may harden abnormally, infection, and recursion despite the medication.

Hydrocelectomy- It is a procedure that involves the surgical removal of the sac as well as the fluid. Since it is a minor surgery, it only takes about an hour, and in most cases the patient can go home the same day.   The surgery begins with the doctor giving the patient general or spinal anesthesia, following by him making a small cut in the scrotum or the lower abdomen. After this the fluid is drained, the sac is removed, and finally the cut is sealed with stitches.