Hydrocele – A hydrocele is a fluid-filled sac that surrounds the testicle, resulting in swelling of the scrotum. Up to 10% of male infants have a hydrocele at birth, but most disappear spontaneously without treatment. Adult males can develop a hydrocele due to inflammation or injury within the scrotum. Hydroceles typically are not painful; however, if they become large, they can become uncomfortable.
Evaluation: A careful history and physical examination is the first step in evaluating a patient with a hydrocele. The urologist may schedule a scrotal ultrasound to rule out other problems, including testicular cancer. In some instances, it is difficult to distinguish a hydrocele from a hernia.
Treatment: Unless the hydrocele is large and symptomatic, observation is recommended. When treatment is indicated, surgical drainage is performed in the outpatient setting. A small incision is made into the scrotum. The fluid is drained and the sac is excised. The scrotal skin is left intact.
Spermatocele (epididymal cyst) – A spermatocele is a cystic mass containing sperm. It lies above and behind the testis and is attached to the epididymis. Most spermatoceles are less than 1 cm in diameter and identified by physical examination or scrotal ultrasound. Spermatoceles require treatment when they become large enough to annoy the patient. Surgical excision is recommended in patients who require treatment.
For more information go to Varicoceles.