Hydrocoel

Hydrocoel refers to a rare and benign condition characterized by the accumulation of serous fluid within the tunica vaginalis, the sac that encloses the testis. It is essentially a type of hydrocele, but the term hydrocoel is sometimes used specifically in certain contexts. The tunica vaginalis is a double-layered membrane that is a remnant of the peritoneum, which descends with the testis during fetal development. Normally, only a small amount of lubricating fluid is present between these layers. In a hydrocoel, this fluid volume increases significantly, causing the scrotum to swell.

The exact cause of hydrocoel formation is not always clear, but it is thought to be related to an imbalance between the production and absorption of fluid by the tunica vaginalis. It can be congenital, meaning present at birth, often due to a persistent processus vaginalis which is a connection between the abdominal cavity and the scrotum. Acquired hydrocoels can develop later in life due to factors such as inflammation, infection, trauma to the scrotum, or as a complication of other scrotal surgeries.

Symptoms of a hydrocoel are primarily scrotal swelling, which can range from mild to significant. The swelling is typically painless, smooth, and may feel like a water balloon. In some cases, a large hydrocoel can cause discomfort or a feeling of heaviness. Diagnosis is usually made through a physical examination, and transillumination, where a light is shone through the scrotum, can help confirm the presence of fluid as it will glow. Ultrasound is often used to rule out other scrotal pathologies. Treatment is generally not required for small or asymptomatic hydrocoels. However, if the hydrocoel is large, causing discomfort, or if there is concern about an underlying cause, surgical intervention, known as a hydrocelectomy, may be performed to remove the excess fluid and excise the hydrocele sac.