Basak Kandi
In mean vaginal hydrocele is the most common morbidity due to Wuchereria bancrofti. Diagnosis is straightforward most of the time but when the swelling is not transilluminant, patients in whom the diagnosisis in doubt, children with hydroceles and those with co-morbid conditions should have ultrasonography to differentiate these swellings [1]. Studies on the effect of medical treatment with diethylcarbamazine on the size of hydroceles are inconclusive. The only effective treatment for hydrocele issurgery as the minimally in invasive therapy like aspiration and sclerotherapy are known to have high recurrence rates. Several surgical options are available for managing hydrocele but the recommended operation is hydrocelectomy, i.e. a subtotal excision of the parietal layer of the tunica vaginalis leaving a rim of approximately one-centimeter width around the testis and epididymis [2].
A hydrocele is an abnormal collection of serous fluid between the two layers of tunica vaginalis of testis [3]. It can either be congenital or acquired.
Congenital hydrocele results from failure of processus vaginalis to obliterate [4]. During development, the testes are formed retroperitoneally in the abdomen and proceed to descend into the scrotum via the inguinal canal in the third gestational week. This descent of the testes into the scrotum is accompanied by a fold of peritoneum of the processus vaginalis. Normally, the proximal portion of processus vaginalis gets obliterated while the distal portion persists as the tunica vaginalis covering the anterior, lateral, and medial aspects of the testes. The tunica vaginalis is a potential space for fluid to accumulate, provided the proximal portion of processus vaginalis remains patent and results in free communication with the peritoneal cavity, leading to congenital hydrocele [5].
Surgery is the treatment of choice for hydrocele, and it is warranted when hydrocele becomes complicated or symptomatic. For congenital hydroceles, herniotomy is performed, provided they do not resolve spontaneously [6]. On the other hand, acquired hydroceles subside when the primary underlying condition resolves.
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