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Hydrocele - Causes

Causes

Hydroceles can be present at birth due to a patent processus vaginalis or develop at a later age due to an infection or inflammation of the testis.

Primary or Congenital Hydroceles

At about the eighth month the testicles descend from the developing abdominal cavity into the scrotum. A sac (processus vaginalis) accompanies each testicle, allowing fluid from the peritoneal cavity to reach the scrotum and surround the testis. By the time the baby is born or within a few months afterwards the sac closes.

In some cases the sac closes but the fluid remains and the condition is known as a Noncommunicating Hydrocele. Because the sac is closed, fluid cannot flow back into the abdomen. Usually the fluid gets absorbed within a year.

In some cases, however, the sac remains open and the fluid in the sac communicates with that present in the abdomen and it is known as Communicating Hydrocele.

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Adult Onset or Secondary Hydroceles

In older men, any process that acts to stimulate increased production of watery fluid by the tunica or decrease the absorption of this fluid by the scrotal lymphatics or venous system will result in the formation of a hydrocele.

Increased production of fluid could be due to:

  • Inflammation of the testis (orchitis) or epididymis (epididymitis) caused by tuberculosis and by tropical infections such as filariasis.
  • Testicular torsion (rotation of the testis) may cause a reactive hydrocele in 20% of cases.
  • Tumors of the testis, especially germ cell tumors or tumors of the testicular adnexa may cause hydrocele.
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Decreased resorption of fluid could be due to:

  • Surgery in the inguinal region or a renal transplantation can affect the lymphatics or venous system causing decreased absorption.
  • Radiation therapy is associated with cases of hydrocele.
  • Peritoneal dialysis and ventriculoperitoneal shunts.

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