Hydrocele - Types

Types

Hydroceles can be of two types - Primary or Secondary. Primary if fluid accumulates due to a congenital defect and secondary if it is due to irritation of the Tunica Vaginalis.


Hydroceles can be either on one or both sides of scrotum.

Primary or Congenital Hydroceles

The testis usually descends down into scrotum from the abdomen and in so doing it drags a covering of the abdomen along with it. Initially in an infant there maybe some communication with the abdomen however it soon closes. If this communication is large, a hernia results but if the communication is small some amount of fluid from the abdominal cavity can trickle down and accumulate as hydrocele in a baby. Most of these small openings resolve by one year of age.

If the communication with the abdominal cavity is persistent and remains open then it is called a communicating hydrocele. If the opening closes but the fluid remains and does not get absorbed it is called a noncommunicating hydrocele.

Secondary Hydroceles

Adult hydroceles are usually late-onset and secondary to local injury, infections, and radiotherapy. They may present as an acute or chronic entity.

Premature birth may be associated with a hydrocele. In children hydrocele can occur after a varicocele repair of the cord. Sometimes hydrocele maybe associated with a hernia.

The investigations or treatment of primary or secondary hydrocele is the same hence in certain ways it does not matter what kind of hydrocele a person has.

Hydroceles may also be either a hematocele or pyocele.


Hematocele (the prefix Hemo- means 'blood') - If the fluid in the Tunica Vaginalis is blood, it is called Hematocele

Pyocele (the prefix 'pyo'- means 'pus'). - if the fluid gets infected it is called pyocele.

Chylocele -collection of chyle or fat in the tunica vaginalis.

References:

1. British Journal of Surgery, Volume 73, Issue 1, Pages 77 � 78, Dec 2005
2. Michael E, Bundy DA, Grenfell BT. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology 1996;112:409-28.
3. Kumari KA, Harichandrakumar KT, Das LK, Krishnamoorthy K. Physical and psychosocial burden due to lymphatic filariasis as perceived by patients and medical experts. Trop Med Int Health. 2005;10:567�573. doi: 10.1111/j.1365-3156.2005.01426.x.
4. Hydrocele in Emergency Medicine - (https://emedicine.medscape.com/article/777386-overview)
5. Hydrocele - Overview - (https://www.mayoclinic.org/diseases-conditions/hydrocele/symptoms-causes/syc-20363969)
6. What is a hydrocele? - (https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/hydrocele-in-adults#nav-1)

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