• Definition: painless accumulation of fluid in a sac around one or both testicles which derives from the tunica vaginalis, a tissue covering the testes
• Etiology
  • Idiopathic (most common)
  • Congenital hydrocele
    • Communicating hydrocele
      • Occurs due to the failed closure of the processus vaginalis during development
      • Intestinal organs may also protrude through the processus and form an inguinal hernia.
      • Communicating hydroceles increase in size with the Valsalva maneuver and are reducible.
    • Noncommunicating hydrocele: no connection to the peritoneal cavity present
      • Due to extensive secretion and/or reduced reabsorption of fluid.
      • This type of hydrocele is not affected by the Valsalva maneuver and not reducible.
  • Acquired hydrocele
    • Secondary to underlying pathology (e.g., trauma, tumor, torsion, infection)
• Clinical features
  • Fluctuant, painless swelling of affected scrotum
  • Positive transillumination