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Hydrocele - Investigations

Investigations

Some of the Investigations carried out to detect a hydrocele are described below.

A Blood Count and Urine Analysis can help rule out the presence of an infection.

Imaging Studies - The usual imaging study done is an Ultrasound of the scrotum. It is rare to perform a Colour Doppler or an Isotope Scintigraphy unless other pathologies are suspected.

Imaging Studies can help rule out the presence of a coexisting Hernia or other causes of scrotal swellings like a tumour or an infection.

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  • Inguinal-scrotal imaging ultrasound
    • This study is indicated to confirm the diagnosis.
    • May be useful to identify abnormalities in the testis, cystic masses, tumors, appendages, spermatocele, or associated hernia.
    • In the context of pain or testicular bleeding after trauma, an imaging test can differentiate between a hydrocele and incarcerated bowel
  • Doppler ultrasound flow study
    • This study helps to assess the blood flow to the testis.
    • Done usually to rule out varicocele of the cord. Varicocele can occur due to dilatation of the veins of the cord of the testis.
    • It can also be done to rule out testicular torsion or of traumatic hemorrhage into a hydrocele or testes.
  • Testicular scintigraphy
    • This nuclear scan is particularly useful, especially in children, if testicular torsion is suspected.
    • Decreased or absent flow to one testis or a testicular pole indicates torsion.
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A good history combined with physical examination help to diagnose hydroceles and investigations such as Ultra sonogram and Doppler Studies are reserved to assess the condition of the underlying testis.


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