Varicocele, hydrocele (hydrocele)
Hydrocele is a progressive accumulation of serous fluid between the layers of the testicle, leading to a significant increase in the organ's volume. Sometimes, this pathology is combined with hydrocele of the spermatic cord, known as funiculocele. This anomaly occurs at any age, from birth to old age. In infancy, the condition is transient, and the defect often disappears as the child grows. In adolescents and adult men, the condition requires treatment, as it never resolves and tends to progress.
This article will examine the problems of this pathology, its causes, and symptoms. We will also discuss the modern treatment methods offered at the K+31 Clinic.
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Causes and types of disease
The classification of hydrocele in men is based on the characteristics of the cause and severity. Urologists distinguish several groups to determine the pathology.
By origin:
- Physiological (in children under one year of age)
- Congenital (in preschoolers)
- Acquired (in preschoolers, schoolchildren, adolescents, adults)
The congenital form is divided into:
- Isolated; or simple
- Communicating
Acquired forms are divided into:
- Post-traumatic
- Post-surgical. For example, hydrocele after varicocele, especially after surgery using the classic open technique.
- As a complication of inflammatory processes
- A consequence of lymphostasis
- Impaired fluid absorption by the organ membranes and blood vessels
According to the course of the disease, hydrocele can be:
- Gradually developing, chronic
- Acute
By side involvement:
- Left-sided
- Right-sided
- Bilateral
By fluid volume:
- Small. The amount of discharge is no more than the volume of the testicle itself.
- Moderate. The fluid content occupies the volume of 3-4 testicles.
- Large. Fluid content is more than 200-300 ml.
- Giant. Volume is 1-3 liters. Cases have been reported where the fluid volume has reached 23-26 liters.
It is not uncommon for the exact cause of the acquired anomaly to be impossible to determine. This is called an idiopathic form.
Secondary pathology can occur against the background of serious chronic diseases, such as damage to internal organs with renal, hepatic, or cardiovascular failure, or arterial hypertension. Testicular hydrocele is most often observed in conjunction with hemorrhoids and varicose veins of the lower extremities.
Symptoms of hydrocele
The most common course of the disease is asymptomatic. Even with significant scrotal enlargement, pain may be absent.
Pathology can be suspected by the following signs:
- Visible enlargement on one or both sides
- The testicle is difficult to palpate. Fluctuation and the presence of fluid under the membranes are felt.
- Excessive exudate volumes of 200-300 ml lead to pain in this area due to compression of surrounding tissues and testicles.
- As the disease progresses, erectile and sexual dysfunction occurs in adults.
- The scrotum becomes more painful during sports, physical activity, sudden jumps, and pressure changes (for example, on an airplane).
- Enlargement of regional lymph nodes may be observed in advanced stages of the disease.
- Urination problems: urinary retention, false urge to urinate, etc.
Orchitis can cause reactive hydrocele, which manifests as:
- Sharp pain
- Redness of the skin, high local temperature
- Increased overall body temperature, fever, signs of general intoxication
With a communicating cavity, fluid can drain during sleep, so a smaller scrotum may be noticeable upon awakening. Fluid accumulation in several chambers along the inguinal canal results in an hourglass-like appearance.
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General information
Diagnostics
Important! Any changes in the scrotal area or negative sensations should prompt immediate consultation with a urologist. Oncological processes have similar symptoms, so early diagnosis is vital.
The doctor first collects a medical history and conducts a physical examination. A diagnostic program is prescribed to confirm the diagnosis and clarify the specific features of the disease.
Instrumental examination methods:
- Diaphanoscopy, or examination of the organ by light using a special flashlight
- Ultrasound of the scrotal area
- Ultrasound with Doppler ultrasonography of blood vessels
Laboratory tests are additionally prescribed to rule out infection and inflammation, clarify the body's condition, and identify the impact of disease on testicular function.
The following may be prescribed:
- General blood and urine tests
- Blood biochemistry
- Blood clotting test
- Urethral smear test for urogenital infections
- Spermogram to assess spermatogenesis
- Tumor marker testing if neoplastic disease is suspected
In case of complications or concomitant diseases, consultations with related physicians may be prescribed – phlebologist, cardiologist, surgeon, nephrologist, or general practitioner. If necessary, the diagnostic program can be expanded with other tests.
Treatment of hydrocele at K+31
The solution to your problem should begin with a consultation with the urologists at the K+31 Clinic in Moscow. Our in-house laboratory and advanced diagnostic equipment allow us to perform examinations with high diagnostic value.
Doctors prescribe an individualized treatment plan for each clinical case. We offer medical services that meet modern medical standards.
The K+31 Medical Center's competitive pricing policy makes prices affordable for all patients. The clinic often offers special discounts and promotions. You can choose the services you need and learn more about the medical facility and its specialists from patient reviews.
You can ask the administrator your questions or schedule a consultation by calling the clinic or using the contact form on the official website.
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Features of the pathology
Hydrocele in infants is a physiological phenomenon that resolves by one to two years of age without requiring treatment. Treatment is only necessary if complications or concomitant conditions are present, such as scrotal hernia, strangulation, or inflammation.
However, scrotal swelling is a common symptom of other pathologies:
Accurate diagnosis requires not only an examination but also the use of instrumental and laboratory tests.
The amount of fluid can be 50-200 ml. However, it's not uncommon for the volume to accumulate to one to three liters. This greatly complicates not only the person's condition but also their ability to perform normal activities. Movement, work, and sexual activity become problematic.