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Hydrocele, Emergency Medicine

Jessica L. Osterman Reviewed 06/2017
 


Basics

Description

  • Most common cause of painless scrotal swelling.

  • Classified as congenital or acquired (secondary):

    • Congenital result from a patent process vaginalis and communication between tunica vag...

Diagnosis

Signs and Symptoms

Painless scrotal swelling with a sensation of pulling, dragging, or heaviness. 

History

History and exam with special attention to identifying torsion of testicle. 

Physical Exam

Treatment

Initial Stabilization/Therapy

Stabilization should focus on underlying cause (e.g., trauma). 

Ed Treatment/Procedures

Appropriate exam of testicle to exclude primary neoplasm and referral. 

Medication

Follow-Up

Disposition

Admission Criteria

Patients with secondary hydrocele may need admission for further evaluation of underlying pathology (e.g., neoplasm, trauma). 

Discharge Criteria

  • Otherwise healthy...

Pearls and Pitfalls

The mass may fail to transilluminate due to thickening of the tunica vaginalis. 
  • Bedside US should visualize both the fluid-filled mass and the testicle.

Additional Reading

  • Cokkinos  DD, Antypa  E, Tserotas  P, et al. Emergency ultrasound of the scrotum: A review of the commonest pathologic conditions. Curr Probl Diagn Radiol.  2011;40(1):1–14.

  • Hoe...

Codes

ICD9

  • 603.1 Infected hydrocele

  • 603.9 Hydrocele, unspecified

  • 778.6 Congenital hydrocele

  • 603.8 Other specified types of hydrocele

  • 603.0 Encysted hydrocele

  • 603 Hydrocele

ICD10

  • N43.1 Infected hydrocele

  • N43.3 ...

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