A Family Doctor's Tale - HYDROCOELE

DOC I HAVE ENLARGED TESTIS

Hydrocoele is the excess accumulation of fluid inside the sac containing your testis.


The causes of Hydrocoele are mostly due:

A.Congenital:

Children are born with with enlarged testicular sac with fluid which communicate with abdominal cavity through a patent duct which should be closed at birth.


B.Infections:

Infections of the testicle can cause inflammation of the cavity surrounding the testicle and its appendages.


c. Obstruction to fluid flow:

Obstruction to lymphatic and venous flow in the testicular cavity prevents the fluid in the testicular cavity from being resorbed into the general system.


The Symptoms of Hydrocoele are:

1.heaviness and fullness of the scrotum


2.enlargement of scrotum usually on 1 side


3.usually painless except when inflmmed or infected


Signs:

1.redness and swelling of the scrotum


2.enlargement of the scrotum on 1 side


5.Inguinal lymph nodes may be swollen and painful if there is severe infection(rare)


Complications of Hydrocoele are:
1.Abscess formation


2.torsion of the testicle(rare)


Diagnosis is by:
1. clinical features and transillumination of scrotal swelling


2. Ultrasound scan of the scrotal swelling to exclude any tumors of the testicle or torsion.


Treatment is by:
1. Aspiration of the fluid in the scrotal cavity usually helps to reduce swelling but recurrences are common


2.Rest and support of the scrotum with loose underwear


3. surgery with drainage of fluid from scrotum.
The scrotal cavity is opened up and the fluid drained.
If the testicle is normal it should be left alone.
If the testicle is disease and shrunken, it is usually removed.


Most cases of Hydrocoele usually will recover with surgical treatment.


Aspiration is a temporary measure as recurrences are common.



Avoid too tight underwear which can obstruct the lymphatic or blood vessels of the scrotum.