Hydrocele is an accumulation of serum in the scrotum. Normally there is a limited amount of serum within the scrotum and in the walls of the testicles to serve as protection against friction and for better health of the cells, but under certain conditions this fluid increases in quantity and may become extreme in amount.
While there is little pain or distress with this condition there often is insufficient swelling to cause much inconvenience. When appearing later in life it usually results from injury to the testicle, from gonorrheal infection, from obstruction of the abdominal veins, or tuberculosis or general dropsy. It may cause sufficient pressure upon the testicle and spermatic vessels to have the effect of causing atrophy or defective functioning of these glands.
Hydrocele may exist from birth (congenital hydrocele). This condition like a rupture, is reducible, for the scrotum communicates with the internal abdomen. Again, like a rupture, it may show an impulse on coughing.
In acquired hydrocele the communication with the abdominal cavity is cut off in the inguinal canal (in the abdominal wall) so that the swelling is not reducible and there is no impuls on coughing. Encysted hydrocele is another form involving mainly the scrotal portion of the spermatic cord. This form may arise from either the testicle or the epididymis, an elongated body attached to the testicle, in the scrotum.
Congenital hydrocele often terminates spontaneously in the course of time, although usually it is necessary to wear a special support. Sometimes a simple surgical operation may be advised, this consisting purely of eradicating the neck of the sac. Sometimes a congenital hernia (or rupture) enterprises this condition, because of the abnormal opening in the inguinal canal. Many cases of hydrocele are incurable except by surgery, for even if one succeeds in reducing the accumulated fluid, more very likely will re-form without the sac of the tunica is eradicated.
Treatment. In those cases where the individuals do not wish to submit to operation, natural methods may be tried – though the prospects of complete cure are not bright. Both local and constitutional treatment will be required. It may be necessary to build up or restore vitality to a high degree. The cold sitz-bath upon arising and upon retiring is one of the best local treatments. It is not advisable to continue these baths long enough to prevent prompt reaction to warmth upon terminating the bath. After the cold sitz-bath taken shortly before retiring, a cold wet cloth should be applied to the affected part. This may be held fairly snugly in place by an athletic supporter or by a "T" -bandage.
The "T" -bandage is a waist band four to six inches in width to the center of which is sewed at right angles, a similar strip which is brought up between the thighs and pinned to the front of the waist band after this has been Pinned snugly in place.
If the cold sitz-bath is taken for a few days without noticeable results, it may be beneficial to apply a mud pack at night, held in place by the "T" -bandage and removed in the morning. The cold sitz-bath may be taken upon its removal. Exercises taken head down on an inclined board, or a similar position taken without exercise, will be of some benefit in the congenital type, but will have less effect in other types.
Fasting may be employed with temporary favorable results. The fluid not infrequently reduces appreciably when food is withheld and a limited amount of fluid drunk. But the tension in this condition is for the fluid to re-accumulate shortly after resuming eating and drinking the normal amount of fluid.
As has been stated, surgical interference usually will be necessary in this condition. The operation does not involve removal of any structure but strictly correcting a difficulty. The type of surgical procedure will be determined by the physician or surgeon, and of course will depend upon the type and severity of the affliction and the age and condition of the patient.