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Hydrocele, Pediatric

Adam B. Hittelman, MD, PhD, FACS Reviewed 10/2018
 


BASICS

DESCRIPTION

A hydrocele is the accumulation of fluids around the testicle, within the tunica vaginalis or processus vaginalis. 
  • Communicating hydrocele: fluid passing from peritoneal cavity into ...

DIAGNOSIS

HISTORY

  • Inguinal or scrotal/labial swelling

  • Age of onset

    • Birth, after birth, >12 years old

  • Laterality

  • Fluctuation in size: smaller in morning and larger over day in response to activity and up...

TREATMENT

GENERAL MEASURES

  • Conservative management for babies presenting at birth with noncommunicating hydrocele (no fluctuation in size) for 24 months

    • Consider surgical intervention if persistent >...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Serial physical exam (q4–6mo in babies; annual for adolescent) for nonoperative management

    • Consideration of ultrasound for very tense hydrocele, preventing palpati...

ADDITIONAL READING

  • Cimador M, Castagnetti M, De Grazia E. Management of hydrocele in adolescent patients. Nat Rev Urol.  2010;7(7):379–385. [View Abstract on OvidInsights]

  • Clarke S. Pediatric ingu...

CODES

ICD9

  • 603.9 Hydrocele, unspecified

  • 603.8 Other specified types of hydrocele

  • 778.6 Congenital hydrocele

  • 603.1 Infected hydrocele

  • 603.0 Encysted hydrocele

ICD10

  • N43.3 Hydrocele, unspecified

  • N43.2 Other hyd...

FAQ

  • Q: Do hydroceles need to be corrected?

  • A: Noncommunicating hydroceles can be managed conservatively and commonly will resolve within the first 12 to 24 months of life. Watchful waiting is recommend...

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