First of all, one needs to be well acquainted with the details of a hydrocele and its overall effects.
The accumulation of clear fluid between the testis and tunica vaginalis leads to hydrocele testis. It causes local discomfort and progressive swelling on the scrotum’s affected side. In spite of generally occurring on one side, a hydrocele can also affect both the sides. A tumour, varicocele’s surgery, physical trauma or infection can be the underlying cause of the accumulation.
The swelling of primary hydroceles is non-tender and soft. The size of the swelling is large in size on examination. Being painless, these hydroceles are often ignored which leads to the gradual increase in their size. Atrophy of testis is caused by the long-continued duration of large hydroceles due to the obstruction or blood supply or compression. A hydrocele is commonly diagnosed by attempting to transilluminate the enlarged scrotum. The light will usually pass through a hydrocele. However, it won’t pass through a tumour, with the exception of a malignancy with reactive hydrocele.
Testicular diseases cause secondary hydrocele. The infants undergoing peritoneal dialysis can also have an occurrence of secondary hydroceles. If a presence of a testicular tumour is detected in a hydrocele, then it must be removed clinically. A secondary hydrocele is often associated with chronic or acute epididymo-orchitis. It is also detected with some testicular tumours and torsion of the testis. A secondary hydrocele is medium-sized and usually lax. After the primary lesion resolves, a secondary hydrocele subsides.
Patent processes vaginalis leads to hydrocoele in children and infants. The inguinal ring is distended with the processes vaginalis and the tunica but it is not connected with the peritoneal cavity. The processus vaginalis connects with the peritoneal cavity and is patent. The herniation of intra-abdominal contents is not allowed due to small communication. The hydrocele is not usually emptied by the digital pressure. However, when the child is lying down, the hydrocele fluid may drain into the peritoneal cavity. In the case of bilateral swellings, ascites should be considered.
A smooth oval swelling can be mistaken as an inguinal hernia near the spermatic cord. If the testis is pulled downwards with gentle care, them the swelling becomes less mobile by moving downwards. The chances of a hydrocoele being developed in a remnant of the processes vaginalis along the spermatic cord are quite rare. This hydrocele is called an encysted hydrocoele of the cord and it also transilluminates. A good care should be taken for differentiating a tumour of the testicle or hydrocele from a scrotal hernia. For an accurate diagnosis, ultrasound imaging is beneficial. A hernia is not translucent, can be reduced and transmits a cough impulse. No impulse is given by a hydrocele of a hernia is absent. It also cannot be reduced into the inguinal canal. A complete congenital type of hernial sac is often associated with a hydrocele in children.
Now coming to the question ‘I am diagnosed with hydrocele. Will it affect my fertility?’ – A hydrocele does not have any direct effect on late fertility. Rather an actual pathological entity, a hydrocele is more of a symptom. Practically, a hydrocele does not need immediate surgery. However, surgery makes good sense for ensuring no harm in the upcoming time.