HYDROCOELE

A hydrocele is a painless buildup of watery fluid around one or both testicles that causes the scrotum or groin area to swell. Hydroceles usually aren't painful. Typically, it is not harmful.
About one in 10 male infants has a hydrocele at birth, but most hydroceles disappear without treatment within the first year of life. Additionally, men - usually older than 40 - can develop a hydrocele due to inflammation or injury within the scrotum.

Cause:
During normal development, the testicles descend down a tube from the abdomen into the scrotum. Hydroceles result when this tube fails to close. Fluid drains from the abdomen through the open tube. The fluid builds up in the scrotum, where it becomes trapped. This causes the scrotum to become swollen.
Hydroceles normally go away a few months after birth, but their appearance may worry new parents.
In older males, a hydrocele can develop as a result of inflammation or injury within the scrotum. Inflammation may be the result of infection of the small coiled tube at the back of each testicle (epididymitis) or of the testicle (orchitis).

Symptoms:
A hydrocele feels like a small fluid filled balloon inside the scrotum. It is smooth, and is mainly in front of one of the testes. Hydroceles vary greatly in size. Hydroceles are normally painless and harmless. Large hydroceles cause discomfort because of their size. As the fluid of a hydrocele is transparent, light shone through a hydrocelic region will be visible from the other side.
Symptoms of a hydrocele can easily be distinguished from testicular cancer, as a hydrocele is soft and fluidy, where a testicular cancer feels hard and rough.

Risk Factors:
In older age, these are the risk factors responsible for its develpoment-
1.Injury to scrotum.
2.Infection.
3.Radiation therapy.

Examinations and Investigations:
During a physical exam, the doctor usually finds an swollen scrotum that is not tender. Often, the testicle cannot be felt because of the surrounding fluid. The size of the fluid-filled sack can sometimes be increased and decreased by pressure to the abdomen or the scrotum.
If the size of the fluid collection varies, it is more likely to be associated with an inguinal hernia.
Hydroceles can be easily demonstrated by shining a flashlight (transillumination) through the enlarged portion of the scrotum. If the scrotum is full of clear fluid, as in a hydrocele, the scrotum will light up.
The presence of erythema and edema with loss of the normal scrotal rugae is suggestive of an inflammatory lesion (i.e., epididymitis or epididymo-orchitis.) In the presence of acute epididymitis, the epididymis is exquisitely tender to palpation and, in the absence of orchitis, easily separated from the normal testicle. Pain is aggravated by standing and should be relieved when the testicle is elevated (Prehn's sign).
A smooth, cystic feeling mass completely surrounding the testicle and not involving the spermatic cord is characteristic of a hydrocele. A cystic, non-tender mass arising from the head of the epididymis and distinct from the testicle is characteristic of a spermatocele.

An ultrasound may be done to confirm the diagnosis.
Treatment:
A small and asymptomatic hydrocele does not requires any therapy except reassurance.
But treatment requires in cases when hydrocele causes pain or embarrassment or when they decrease the blood supply to the penis (rare).
Aspiration of the excesssive fluid was done in hydrocele. But after draining the fluid there will be chances of recurrence. If the hydrocele gets larger or causes discomfort, surgery to remove the hydrocele (hydrocelectomy) may be needed.
Homoeopathy - the medicines selected in case of hydrocele totally depends on the (w)holistic approach. The medicines are selected depending upon the constitution of the patient and causative factor. The chances of recurrence is usually nil in cases where hydrocele is treated homoeopathically.

Please E-mail dr_ramanand@rediffmail.com for any questions/treatment