Presentation
Presentation Scrotal enlargement with a non-tender, smooth, cystic swelling. [patient.info]
They also presents with a fluid like collection in the scrotum that transilluminates. [lecturio.com]
But the reason why some children present with hernia and some with hydrocele is not yet clear. Histological examination of the sac may be useful in understanding the reason for this differential presentation. [ijpediatrics.com]
Hypertrophied scars were present at base of the testis and suprapubic region [Figure 2]. [urologyannals.com]
Entire Body System
- Wound Infection
Complications of operations for hydroceles are very uncommon and may include: Wound infection. Infertility which may occur with bilateral injury to the vas deferens. Testicular atrophy which may occur due to injury to the testicular blood supply. [patient.info]
Wound infection or bleeding may occur with any operation, but are uncommon. Injury to the testicular blood vessels or vas deferens (the tube that carries sperm) may occur during a hydrocele or hernia operation. [uichildrens.org]
Recurrence following inguinal hernia surgery range is related to factors such as prematurity, 21 increased abdominal pressure, postoperative wound infection, and hematoma, as well as surgical experience. [ipeg.org]
Wound infection and hematoma are also uncommon. A recurrent hydrocele occurs infrequently after both scrotal and inguinal approaches. There is a less than 5% risk of recurrence of the hydrocele. [cancertherapyadvisor.com]
- Lymphadenopathy
An associated inguinal hernia is present in approximately one-third of cases. 5 The differential diagnosis includes indirect inguinal hernia, endometriosis of the round ligament, inguinal lymphadenopathy, volvovaginal cysts and tumors, such as Bartholin [appliedradiology.com]
Prior to radical left inguinal orchiectomy, whole-body PET-CT was performed and revealed no evidence of local lymphadenopathy or distant metastasis. [spandidos-publications.com]
[…] variant Persistent communication with the peritoneal cavity No Yes Etiology Defective closure at both proximal and distal ends of processus vaginalis Defective closure of the distal end of tunica vaginalis Macroscopic differential diagnosis Inguinal lymphadenopathy [pathologyoutlines.com]
The CT scan report was therefore, summarized as: (a) Both right and left sided para-aortic lymphadenopathy was noted in the abdomen but there are no pelvic lymph nodes. (b) No evidence of visceral metastases. (c) Normal appearances of the bones. [webmedcentral.com]
- Inguinal Mass
Ultrasound examination of the inguinal mass was performed (Figure 1-3). [appliedradiology.com]
The omentum may become entrapped in a hernia, causing chronic abdominal pain with a persistent inguinal mass. In females, the ovary or fallopian tube can enter hernia sacs and become incarcerated or strangulated. [emedicine.medscape.com]
- Pathologist
Emojis for the Surgical Pathologist S. [semanticscholar.org]
For this purpose, coordination among radiologists, pathologists, and surgeons is vital for better patient outcomes. [ncbi.nlm.nih.gov]
Cardiovascular
- Thrombosis
Excludes: psychogenic impotence ( F52.2 ) N48.5 Ulcer of penis N48.6 Induratio penis plastica Peyronie's disease Plastic induration of penis N48.8 Other specified disorders of penis Atrophy Hypertrophy Thrombosis } } } of corpus cavernosum and penis N48.9 [apps.who.int]
He had no identifiable risk factors for a deep vein thrombosis. He had no bowel or bladder symptoms. The patient did not report any previous surgery or trauma to the region. [casesjournal.biomedcentral.com]
[…] with torsion of the spermatic cord) Intravaginal; extravaginal (prenatal or neonatal) Appendiceal torsion, testis or epididymis Testicular infarction due to compressive hydrocele or hernia Testicular infarction due to other vascular insult (cord injury,thrombosis [auanet.org]
Nazir SS, Khan M: Thrombosis of the dorsal vein of the penis (Mondor's Disease): A case report and review of the literature. Indian J Urol 2010;26:431-433. Dandapat MC, Padhi NC, Patra AP: Effect of hydrocele on testis and spermatogenesis. [karger.com]
Neurologic
- Irritability
E) Sclerotherapy Sclerotherapy involves injecting tetracycline inside the sac or other irritants after emptying it, but this may cause an obstruction of the epididymis. [pagniurologia.it]
The reason for fluid accumulation usually is irritation of the mesothelial lining caused by hernia, scrotal trauma, epididymo-orchitis, or tumors of the testis or paratesticular region. [webpathology.com]
Discuss with Paediatric surgeon Incarcerated hernia Intermittent inguinoscrotal swelling, associated irritability +++Pain Worse with crying Nausea and Vomiting – if bowel entrapment Firm, tender, irreducible inguinoscrotal swelling Requires reduction [rch.org.au]
In addition, irritability, vomiting, and abdominal distention may be the signs of an incarcerated hernia, especially in a baby with a communicating hydrocele. Rarely, hydroceles can occur in females along the canal of Nuck. [online.epocrates.com]
Guardal M and Erol A, 22 believe that chronic hydrocele may be the cause of malignant mesothelioma by chronic irritation. [webmedcentral.com]
Urogenital
- Scrotal Mass
Symptoms The most common presentation is that of a chronic scrotal mass that is progressively increasing in size and painless. The mass may be of differing size as in communicating hydrocephalus. [lecturio.com]
Algorithm of the likely diagnoses of a scrotal mass based on physical examination findings. Diagnosing Scrotal Masses Figure 1. Algorithm of the likely diagnoses of a scrotal mass based on physical examination findings. Figure 2. [aafp.org]
History and exam Key diagnostic factors scrotal mass transillumination enlargement of scrotal mass following activity variation in scrotal mass during the day More key diagnostic factors Risk factors male sex prematurity and low birth weight infants < [bestpractice.bmj.com]
Quick Reference Key Factors scrotal mass transillumination enlargement of scrotal mass following activity variation in scrotal mass during the day Other Factors More information... 1st Tests to Order clinical diagnosis Other Tests to consider ultrasound [online.epocrates.com]
- Scrotal Pain
Acute scrotal pain, suspected strangulated inguinal hernia or suspected testicular torsion requires immediate referral to the Emergency Department. [pch.health.wa.gov.au]
Malignant mesothelioma of the tunica vaginalis: presenting with intermittent scrotal pain and hydrocele. Case Rep Med. 2012;2012:189170.). [scielo.br]
Inability to fully examine the testis, or the presence of other signs and symptoms such as fever, scrotal pain, erythema or swelling, abdominal pain or incomplete transillumination are indications for scrotal ultrasonography. [cancertherapyadvisor.com]
Clinical examination often yields nonspecific signs and symptoms such as scrotal pain, swelling or a palpable scrotal mass. [e-ultrasonography.org]
- Testicular Mass
A hydrocele must be distinguished from a true testicular mass, and transillumination may help, because the hydrocele will transilluminate but a testicular mass will be opaque. [library.med.utah.edu]
Microcalcifications associated with a testicular mass in a 32-year-old male with a non-tender left scrotal mass. A, B. [e-ultrasonography.org]
Scrotal ultrasonography is mandatory in nonpalpable testicles to rule out a subtending testicular solid mass requiring inguinal exploration. Otherwise, open hydrocelectomy via a scrotal incision is the standard treatment of idiopathic hydroceles. [nature.com]
[…] life-threatening diseases (e.g., testicular carcinoma), any patient with a new or changing scrotal mass should be evaluated immediately in the office or emergency department. [aafp.org]
- Testicular Pain
Diagnosis Features on history Features on exam Management Surgical Causes Testicular torsion Peak neonates and adolescents 13-16years Sudden onset unilateral testicular pain and swelling Pain usually constant May be pain in iliac fossa May follow minor [rch.org.au]
A 20-year-old male with left testicular pain. [e-ultrasonography.org]
CASE REPORT A 54 year-old male farmer was referred by his GP to our radiology department for a scrotal ultrasound to investigate a two week history of right testicular pain and swelling. [academic.oup.com]
Testicular torsion presents with the rapid onset of severe testicular pain and swelling. The onset of pain may be preceded trauma, physical activity, or by no activity (e.g. during sleep). [auanet.org]
Workup
Sections Hydrocele Overview Practice Essentials History of the Procedure Problem Epidemiology Etiology Pathophysiology Presentation Indications Relevant Anatomy Contraindications Prognosis Show All DDx Workup Approach Considerations Laboratory Studies [emedicine.medscape.com]
The latter is the most common finding in children. 1–5 Inguinal hernia occurs 9 times more commonly in boys than in girls, with the majority occurring on the right (60%), left (25%), and 15% are bilateral. 6,7 Diagnosis and Workup Inguinal hernia Patients [ipeg.org]
Treatment
Complications Complications are attributable to the pathology itself and the treatment administered. [ncbi.nlm.nih.gov]
Differential Diagnosis Differential diagnoses for spermatocele are listed as follows: Hydrocele Varicocele Epididymal cyst Inguinal hernia Treatment Various treatment strategies can be summarized as follows: Treatment plan Explanation Observation with [lecturio.com]
TREATMENT ISSUES FOR REFERRAL Urology referral for symptomatic adults or if underlying diagnosis is unclear Pediatric urology/surgery referral for children with symptomatic noncommunicating hydrocele Ped... [5minuteconsult.com]
Contributor Medical College of the State of South Carolina (Degree grantor) Source WZ 4 M4 1846 v.2 no.14 http://digital.library.musc.edu/cdm/ref/collection/wit/id/19134 Subject Hydrocele--Treatment;Testis--Diseases--Treatment;Dissertations, Academic- [scribe.library.musc.edu]
Prognosis
The prognosis of the adult-onset hydrocele is mainly dependent on the underlying cause. For instance, filarial hydrocele's prognosis depends on its size and the severity of lymphatic obstruction. [ncbi.nlm.nih.gov]
Prognosis The prognosis is dependent on the presence of any underlying cause. Most congenital hydroceles resolve by the end of the first year of life. [patient.info]
ASSOCIATED CONDITIONS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT ISSUES FOR REFERRAL SURGERY/OTHER PROCEDURES ADMISSION, INPATIENT, AND NURSING CONSIDERATIONS ONGOING CARE FOLLOW-UP RECOMMENDATIONS PROGNOSIS [5minuteconsult.com]
treatment, prevention, prognosis, and additional useful information HERE. [dovemed.com]
Etiology
Objectives: Identify the etiology of hydrocele medical conditions and emergencies. Summarize the appropriate evaluation of hydrocele. Review the management options available for hydrocele. [ncbi.nlm.nih.gov]
Patton, MS, MD Reviewed 06/2021 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS COMMONLY ASSOCIATED CONDITIONS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT ISSUES FOR REFERRAL [5minuteconsult.com]
Epidemiology Predominant age: childhood Incidence Estimated at 0.7–4.7% of male infants Prevalence 1,000/100,000 Estimated at 1% of adult men Etiology and Pathophysiology Incomplete closure of the processus vaginalis trapping peritoneal fluid anywhere [unboundmedicine.com]
11 VARICOCELE Defined as an abnormal dilatation and distension of the veins of the pampiniform plexus 12 INCIDENCE 15% in the general population (8% - 23%) 16,3% in adolescents (12,4% - 25,8%) 33% in infertile men (19% - 41%) 58% - 93% left sided 13 ETIOLOGY [slideplayer.com]
Cryptorchidism Definition: failure of one or both testicles to descend to their natural position in the scrotum Epidemiology: most common congenital anomaly of the genitourinary tract [1] Etiology: unknown, possibly multifactorial Risk factors Prematurity [amboss.com]
Epidemiology
Patton, MS, MD Reviewed 06/2021 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS COMMONLY ASSOCIATED CONDITIONS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT ISSUES FOR REFERRAL [5minuteconsult.com]
Epidemiology Predominant age: childhood Incidence Estimated at 0.7–4.7% of male infants Prevalence 1,000/100,000 Estimated at 1% of adult men Etiology and Pathophysiology Incomplete closure of the processus vaginalis trapping peritoneal fluid anywhere [unboundmedicine.com]
Epidemiology of varicocele.. Asian J Androl. 2016; 18 (2): p.179-81. doi: 10.4103/1008-682X.172640. | Open in Read by QxMD Pauroso S, Di Leo N, Fulle I, Di Segni M, Alessi S, Maggini E. [amboss.com]
Pathophysiology
Patton, MS, MD Reviewed 06/2021 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS COMMONLY ASSOCIATED CONDITIONS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT ISSUES FOR REFERRAL [5minuteconsult.com]
Epidemiology Predominant age: childhood Incidence Estimated at 0.7–4.7% of male infants Prevalence 1,000/100,000 Estimated at 1% of adult men Etiology and Pathophysiology Incomplete closure of the processus vaginalis trapping peritoneal fluid anywhere [unboundmedicine.com]
The pathophysiology of hydroceles requires an imbalance of scrotal fluid production and absorption. [emedicine.medscape.com]
[…] a patent processus vaginalis. [2] [3] [7] Patients with connective tissue disorders have a high risk of communicating hydroceles. [3] Outside the US, hydroceles may also be seen in patients with filariasis as a result of lymphatic obstruction. [14] Pathophysiology [online.epocrates.com]
Pathophysiology The testicles are anatomically found just below the kidneys in the peritoneal cavity during fetal development. [news-medical.net]
Prevention
Centers for Disease Control and Prevention (CDC) 1600 Clifton Rd. [dovemed.com]
How can a hydrocele be prevented? The majority of hydroceles in children are congenital and thus cannot be prevented. What is the evidence? Kapur, P, Caty, MG, Glick, PL. “Pediatric hernias and hydroceles”. [cancertherapyadvisor.com]
Prevention Can a hydrocele be prevented? There is nothing you can do to prevent your baby from getting a hydrocele. For adolescent and adult men, the best protection against a hydrocele is to keep the testicles and scrotum free of injury. [my.clevelandclinic.org]
This collection of serous fluid within the tunica vaginalis is usually related to a patent processus vaginalis large enough to allow peritoneal fluid to drain into the scrotum but small enough to prevent hernia. [pch.health.wa.gov.au]