Hydrocele

Inspection:
- swelling over scrotum
- scar - previous surgery, abd scar
- no visible cough impulse - differentiate between inguinal-scrotal hernia

Palpation:
- non tender
- normal temp
- not attached to skin
- can get above - again, differentiate from hernia
- no cough impulse
- +/- testes palpable (palpable in hydrocele of cord)
- fluctuant
- transilluminant
- percuss - dull

examine other testicle + abd + PR

hydroceles can be:
- primary
- secondary

- primary - idiopathic
- secondary

• tumours - testicular tumours
• trauma
• infection - epididymo-orchitis
  

Types:
- vaginal hydrocele
- congenital hydrocele
- hydrocele of cord - testes is palpable

Ix:
- exclude secondary cause - USG scrotum + abd

Mx:
- exclude secondary causes esp. tumours
- NO aspiration (fear of tumour seeding)
- surgical - Jaboulay (incise sac, evert, and approximate), Lord's (lift out testicle, plicate sac)