Patient's question:
Child, male, three months old, the right testicle is larger than the left, and a 1cm-sized mass can be felt connected to the right testicle, with a stalk-like appearance. Is it hydrocele or other diseases?Doctor's answer:
Presentation of Hydrocele of the Tunica VaginalisHydrocele of the tunica vaginalis is mostly unilateral, with bilateral occurrence being less common. The primary presentation is the gradual enlargement of one scrotum, usually without pain. However, when the fluid accumulation is significant or prolonged standing occurs, a heavy dragging sensation may be felt. The surface of the scrotum is typically smooth and shiny, with a strong sense of fluctuation upon palpation. The enlarged scrotum does not shrink due to changes in posture (e.g., lying down) unless it is congenital communicating hydrocele. The testis is generally not palpable, and when a flashlight is shone on one side of the scrotum, a clear red glow may appear on the opposite side (positive transillumination test). If a puncture test is performed, yellowish, slightly viscous fluid can be extracted. Secondary hydrocele of the tunica vaginalis is accompanied by symptoms corresponding to the underlying primary disease.
Mild hydrocele of the tunica vaginalis may not affect fertility, but severe cases can cause the penis to retract into the scrotal skin, impairing normal sexual function. Additionally, prolonged compression of the testis by the fluid can lead to poor local blood circulation, resulting in testicular dysfunction and affecting fertility. The impact of secondary hydrocele of the tunica vaginalis on fertility depends on the condition of the underlying primary disease.