eMedicine Specialties > Emergency Medicine > Genitourinary
Hydrocele: Treatment & Medication
Updated: Nov 25, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Emergency Department Care
- Differentiating between a hydrocele and an acute scrotum (eg, testicular torsion, strangulated hernia) is important.2
- As many as 50% of acute scrotum cases are initially misdiagnosed.
- Transillumination is not diagnostic and cannot rule out an acute scrotum.
- Ultrasound anatomic imaging with Doppler evaluation of testicular blood flow is indicated when an acute scrotum is suspected, as follows:
- A traumatic hemorrhage into a hydrocele or testes
- A testicular torsion with or without a secondary hydrocele
- An ischemic testicle
- In children, hydrocele is treated through inguinal incisions with high ligation of the patent processus vaginalis and excision of the distal sac.2
Consultations
- Immediately consult a urologist if testicular torsion is found or suspected.
- A urologic follow-up examination is required if any testicular pathology is involved.
- A general surgery evaluation is indicated for patients with a tense hydrocele that threatens to embarrass scrotal circulation. Surgical evaluation is also indicated for hydrocele producing a large and bulky mass that is unsightly or uncomfortable.
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| Overview: Hydrocele |
| Differential Diagnoses & Workup: Hydrocele |
Treatment & Medication: Hydrocele |
| Follow-up: Hydrocele |
| References |
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References
Garriga V, Serrano A, Marin A, Medrano S, Roson N, Pruna X. US of the Tunica Vaginalis Testis: Anatomic Relationships and Pathologic Conditions. Radiographics. November-December 2009;29(7):2017-2032. [Medline].
[Guideline] Tekgul S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, et al. Hydrocele. Guidelines on paediatric urology. European Association of Urology, European Society for Paediatric Urology. Mar 2009;[Full Text].
Bayne A, Paduch D, Skoog SJ. Pressure, fluid and anatomical characteristics of abdominoscrotal hydroceles in infants. J Urol. Oct 2008;180(4 Suppl):1720-3; discussion 1723. [Medline].
Bhosale PR, Patnana M, Viswanathan C, Szklaruk J. The inguinal canal: anatomy and imaging features of common and uncommon masses. Radiographics. May-Jun 2008;28(3):819-35; quiz 913. [Medline].
Blaivas M, Brannam L. Testicular ultrasound. Emerg Med Clin North Am. Aug 2004;22(3):723-48, ix. [Medline].
Jayanthi VR. Adolescent urology. Adolesc Med Clin. Oct 2004;15(3):521-34. [Medline].
Lau ST, Lee YH, Caty MG. Current management of hernias and hydroceles. Semin Pediatr Surg. Feb 2007;16(1):50-7. [Medline].
McAchran SE, Dogra V, Resnick MI. Office urologic ultrasound. Urol Clin North Am. Aug 2005;32(3):337-52, vii.
Further Reading
Keywords
hydrocele, hydrocele causes, hydrocele symptoms, hydrocele treatment, defect in tunica vaginalis of scrotum, communicating hydrocele, congenital hydrocele, pediatric hydroceles, indirect inguinal hernias, noncommunicating hydrocele, painless enlarged scrotum
Treatment & Medication: Hydrocele