What is the clinical significance of hydroceles?

Updated: Oct 28, 2020
  • Author: Jacob C Parke, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

The presence of fluid within the hemiscrotum has little clinical impact on the testis. However, determining the cause for the increased fluid, specifically any associated clinically significant pathology, remains the primary concern with regard to hydroceles. Once pathology that is more ominous has been excluded, persistence of the hydrocele or associated discomfort may indicate the need for surgical intervention.

Patients who have undergone varicocelectomy may be an important exception in which a hydrocele may be of clinical importance. This procedure is usually performed when dilated vessels around the testes are believed to increase intratesticular temperatures, thereby leading or contributing to male infertility. Varicocelectomy may damage nearby lymphatic vessels, which may lead to the formation of postvaricocelectomy hydroceles in approximately 7% of patients, potentiating the insulation of the testicle and leading to persistent problems with sperm production. The use of microscopes during this procedure has significantly decreased the incidence of lymphatic obliteration and, therefore, hydrocele formation.


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