ABSTRACT
A hydrocele is a collection of serous fluid in the tunica vaginalis, a membrane that covers the testis. Hydroceles can be primary or secondary to an underlying cause. Primary hydroceles (as in this case) are tense, painless, fluctuant swellings that transilluminate. Because the fluid surrounds the testicle, the underlying testis is often not palpable; however, the epididymis above can be felt as a separate structure. Primary hydroceles are benign, but can be surgically excised if desired. (Simple aspiration of the cyst will result in re-accumulation of fluid.) A secondary hydrocele can occur when the membranous sac around the testis becomes filled with exudates secondary to tumours or inflammation of the underlying testis or epididymis. Secondary hydroceles are usually small and lax. An ultrasound scan should be performed in all adults presenting with a hydrocele to exclude an underlying tumour. Secondary hydroceles require treatment of the underlying condition.
