This document provides information about hydrocele, which is an abnormal fluid collection in the scrotum. It discusses that hydroceles are most common in infants and can be caused by incomplete closure of the tunica vaginalis. Signs include swelling of the scrotum. Diagnosis involves physical exam and sometimes ultrasound. Treatment options include aspiration of the fluid or surgical repair through incision or excision of the tunica vaginalis. Surgery is a minor procedure done as an outpatient to drain the fluid and prevent reaccumulation.

1. R A T H E E S H . R
S L M G N C
HYDROCELE

2. INTRODUCTION
 Hydrocele is an abnormal fluid collection in the
scrotum between the visceral and parietal areas of
the tunica vaginalis.
 In infants is usually the result of incomplete closure
of the process us tunica vaginalis.
 It may or may not be associated with inguinal hernia.
In older boys and men it may be idiopathic but more
likely to be secondary to another pathologic process
in the scrotum or adjacent structures

3. Structure

4. CAUSES
 Infectious disease of Epididymis.
 Local trauma
 Systematic infectious disease like Mumps.
 Imbalance in production and reabsorption of fluid
with in the tunica vaginalis.
 An opening between the peritoneum and tunica
vaginalis.

5. Structure

6. Risk factors
 Most hydroceles are present at birth (congenital),
and babies who are born prematurely have a higher
risk of having a hydrocele.
 Risk factors for developing a hydrocele later in life
include:
 Scrotal injury
 Infection, including sexually transmitted infections

7. SIGNS & SYMPTOMS
 A bulge in the groin
 Scrotal enlargement is the classic presentation of hernia
or communicating hydrocele.
 Pain is generally not a prominent feature but may occur
if a hydrocele expands quickly; tension in the wall may
cause milder pain.
 Hydrocele may become infected and cause pain.
 Frequently, parents report an intermittent bulge. The
bulge may reduce at night in the supine position. A
history of vomiting, colicky abdominal pain, or
constipation suggests bowel obstruction, which may
occur with an incarcerated or strangulated hernia.

8. Cont….
 Constant discomfort
 Embarrassment
 Impaired circulation
 Scrotal mass become large
 Tense

9. Diagnostic Evaluation
PHYSICAL ASSESSMENT:
 The exam may reveal an enlarged scrotum that isn't tender
to the touch. Pressure to the abdomen or scrotum may
enlarge or shrink the fluid-filled sac, which may indicate an
associated inguinal hernia.
 Because the fluid in a hydrocele usually is clear, doctor may
shine a light through the scrotum (transillumination). With
a hydrocele, the light will outline the testicle, indicating
that clear fluid surrounds it.

10. Cont….
 Blood and Urine tests may help determine whether there
is an infection, such as epididymitis.
 The fluid surrounding the testicle may keep the testicle
from being felt. In that case, Ultrasound imaging test is
done.
 Trans-illumination
-This test can rule out a hernia, testicular tumor or
other cause of scrotal swelling.

11. TREATMENT
 Hydroceles usually improve without any treatment
within the first year of life. An operation is usually
only advised if the hydrocele persists after 12-18
months of age.
Surgery
 Aspiration/Surgical Drainage:
- It is treated by aspirating the fluid and injecting
a sclerosing drug such as urea hydrochloride into the
scrotal sac.

12. Cont….
 Incision of Tunica Vaginalis:
> An incision made through the wall of the scrotum
down to the distanced Tunica Vaginalis.
> The sac is resected or after being opened, is sutured
together to collapse the wall.
 Hydrocelectomy:
> Excision of the tunica vaginalis to withdraw the fluid
collection from it.

13. Cont….
 The operation for a hydrocele involves making a very
small cut in the lower tummy (abdomen) or the
scrotum. The fluid is then drained from around the
testicle (testis). The passage between the abdomen
and the scrotum will also be sealed off so the fluid
cannot reform in the future. This is a minor
operation and is performed as a day case, so does not
usually involve an overnight stay in the hospital.
 There are no long-term effects of having a hydrocele.
Having a hydrocele does not affect the testicles
(testes) or a boy's fertility in the future.

14. Potential Complications from Surgery
 Complications from surgery are very rare, but are
more likely if the child has previous groin surgery.
Possible risks include infection, bleeding recurrence,
pulling up of the testicle, and injury to the testicle or
its ducts.

15. Complication
 Haematoma in the loose scrotal tissue
 Testicular Tumor
 Inguinal Hernia.

16. Nursing Diagnosis
 Excess Fluid Volume related to the collection of fluid
in the sac of scrotum as evidenced by enlargement of
scrotum.
 Risk for impaired skin integrity r/t problems in
managing the urine collection appliance.
 Acute pain r/t surgical incision
 Potential for sexual dysfunction r/t structural and
physiologic alterations.
 Deficient Knowledge r/t management of urinary
function.

17. Nursing Management
 A pressure dressing is applied on the scrotum which
is elevated.
 The patient should be observed carefully for any
symptoms of Hemorrhage and Bleeding may not be
external.
 The patient needs a scrotal support when he is up.
 Scrotum is elevated on a pillow or bride dressing.
 Ambulation is encouraged with scrotal support.