Hydrocele - Investigations

Investigations

Some of the Investigations carried out to detect a hydrocele are described below.

A Blood Count and Urine Analysis can help rule out the presence of an infection.


Imaging Studies - The usual imaging study done is an Ultrasound of the scrotum. It is rare to perform a Colour Doppler or an Isotope Scintigraphy unless other pathologies are suspected.

Imaging Studies can help rule out the presence of a coexisting Hernia or other causes of scrotal swellings like a tumour or an infection.

• Inguinal-scrotal imaging ultrasound
• This study is indicated to confirm the diagnosis.
• May be useful to identify abnormalities in the testis, cystic masses, tumors, appendages, spermatocele, or associated hernia.
• In the context of pain or testicular bleeding after trauma, an imaging test can differentiate between a hydrocele and incarcerated bowel
• Doppler ultrasound flow study
  • This study helps to assess the blood flow to the testis.
  • Done usually to rule out varicocele of the cord. Varicocele can occur due to dilatation of the veins of the cord of the testis.
  • It can also be done to rule out testicular torsion or of traumatic hemorrhage into a hydrocele or testes.
• Testicular scintigraphy
• This nuclear scan is particularly useful, especially in children, if testicular torsion is suspected.
• Decreased or absent flow to one testis or a testicular pole indicates torsion.

A good history combined with physical examination help to diagnose hydroceles and investigations such as Ultra sonogram and Doppler Studies are reserved to assess the condition of the underlying testis.

References:

1. British Journal of Surgery, Volume 73, Issue 1, Pages 77 � 78, Dec 2005
2. Michael E, Bundy DA, Grenfell BT. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology 1996;112:409-28.
3. Kumari KA, Harichandrakumar KT, Das LK, Krishnamoorthy K. Physical and psychosocial burden due to lymphatic filariasis as perceived by patients and medical experts. Trop Med Int Health. 2005;10:567�573. doi: 10.1111/j.1365-3156.2005.01426.x.
4. Hydrocele in Emergency Medicine - (https://emedicine.medscape.com/article/777386-overview)
5. Hydrocele - Overview - (https://www.mayoclinic.org/diseases-conditions/hydrocele/symptoms-causes/syc-20363969)
6. What is a hydrocele? - (https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/hydrocele-in-adults#nav-1)

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