ABSTRACT
John of Arderne, the 14th Century English surgeon, noted that the “falynge doune of the guttys into the purs of the testiclys” could lead to intestinal colic and small bowel obstruction. Drainage gives temporary relief, but all too commonly the sac quickly refills. John Douglas, writing in 1755, felt that the wisdom of the ancients had been forgotten and the practice of excising the hydrocele sac was lost. Instead, hydroceles were being managed by cautery, caustics and sclerosants. The treatments had not changed much by the beginning of the 20th Century. Hamilton Bailey, writing in 1936, was still using the two methods of excision of the sac or injection of a sclerosant. The erect penis has long been seen as a symbol of strength, domination and power, so impotence, an inability to generate an erection has, historically, culturally and politically, symbolised a failure of power. Individually too, this can be a devastating psychological blow to a man.
