He is a young fellow in his 20’s. Despite the fact that there were about 15 students in the room, he agreed to show us his scrotal region. He complains of a swelling in his right testicular area, says that it has gradually increased in size over the days. Fear makes people come to the doctors.
On examination, it was diagnosed to be a case of hydrocele. Hydrocele is a condition which can happen both in male and female but most prominently seen in males. It is a condition in which serous fluid accumulates in the processus vaginalis. In other words it means that a swelling appears in the testicular area which may or may not be associated with pain due to accumulation of fluid in a bag like sac called processus vaginalis, which covers the testis.
The cause of hydrocele is unknown in most cases which is known as idiopathic hydrocele, also meaning that we are idiots and can’t discover why that happens. Congenitally it is present in children as well. Trauma to the scrotal region is one of the main reasons why hydrocele occurs. Usually patients also have a history of riding bicycles. Mostly seen in tropical countries.
Hydrocele occurs due to several factors like if the fluid which accumulates is not allowed to drain or if excessive fluid secretion takes place or if the lymphatic supply to the testis is blocked and if there is a tumor in the testis.
Hydrocele can be confused with testicular tumors, epididymal cysts, Spermatocele, chyloceles and filariasis. One of the easiest ways to differentiate it from others is the fact that the fluid that gets accumulated is translucent and when a light is projected at it from the lateral side, the fluid emits a bright red appearance as it can be seen in the picture below.
Temporary the fluid can be drained off but yet again the fluid will appear so surgery is a better option. When performed by skilled surgeons the surgery is simple. Basically what they do is incise the scrotum and open the tunica vaginalis and Evert it, drain the fluid and again anchor it with sutures or the remaining tunica vaginalis is plicated with a series of interrupted absorbable sutures.
If you do not wish to seek any medical treatment then get ready for events such as bursting of the scrotum, followed by perforation, hematoma formation, infection and the increasing fluid will cause the testis to undergo atrophy , meaning that the size of the affected testis will decrease and so will the function and chances of sterility will increase.
Don’t wait for the swelling to be large , go to the nearest doctor for a checkup. Early diagnosis is always better for treatment.
Happy Checking people!