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- A hydrocele is a collection of fluid surrounding one of the testicles. The majority of hydroceles are congenital (present at birth).
- There are two forms of hydrocele:
communicating, and noncommunicating.
- In a communicating hydrocele, there is an open connection between the scrotum and the abdominal cavity; this kind of hydrocele increases the risk of developing a hernia.
- In a noncommunicating hydrocele, no open connection
exists, and there is no increased risk of development of a
hernia.
- The symptoms and therapy are different for the two forms of the disease.
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- Enlargement of one side of the scrotum (both communicating and noncommunicating forms)
- Variation in size of the enlargement at different times of the day (communicating)
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- On physical examination, the physician can shine a flashlight through the mass in the scrotum to make sure it is fluid-filled and not solid.
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- Treatment for communicating and noncommunicating hydroceles differ.
- Noncommunicating:
- No treatment is necessary; the lesion is observed to make sure it resolves over time as the body reabsorbs the fluid
- This can take months to years
- Because of the risk of a hernia, surgery is required to close any connection to the abdominal cavity
- Children are often observed until after the first birthday because the risks of the surgery decrease with age.
- The unaffected side of the scrotum is usually explored to ensure that there is no risk of hernia or hydrocele developing on that side later
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- Children with communicating hydroceles are at increased risk of a hernia (trapping of part of the intestines in the scrotum). This can cause damage to the intestines and lead to serious, life-threatening infections.
- Because of this risk, parents should check the hydrocele of any child who is crying and not consolable, to ensure that it has not markedly and quickly increased in size; this could be the sign of a hernia. These children should be seen by a doctor as soon as possible.
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