NWT Clinical Practice Guidelines for Primary Community Care Nursing - Genitourinary System

Hydrocele (Physiologic)
Definition
In infant boys, a mild scrotal swelling, resulting Complications
from a collection of fluid around the testicle • Slight increase in risk of inguinal hernia
(unilateral or bilateral). It may be confused with a
groin node. Usually present from birth and usually Diagnostic Tests
due to patency of the processus vaginalis. None.

Occurs only rarely in infant girls, in whom it Management

presents as a firm swelling in the groin.
Goals of Treatment
• Observe until condition resolves spontaneously
Cause or surgical referral becomes necessary
Unknown.
Appropriate Consultation
History Consult physician in the following circumstances:
• Painless swelling in scrotum, of variable size • Diagnosis is unclear
• Congenital or acquired • There are signs of complications (e.g. infection)
• Most cases resolve by age 1 year • There is an associated inguinal hernia
• Swelling may fluctuate in size
Nonpharmacologic Interventions
Physical Findings • Explain to parents or caregiver the
• Should be able to palpate an upper border of the pathophysiology of the defect
swelling • Reassure the parents or caregiver
• Testis is usually felt behind the mass, but may • Advise parents or caregiver to return to the
be difficult to feel clinic if the mass enlarges
• Transillumination of the swelling should be
possible Monitoring and Follow-Up
• Inguinal hernia may also be present Reassess every 3 months until resolution occurs or
referral becomes necessary.
Hydrocele of the spermatic cord may also be seen:
• Painless cystic swelling along the inguinal canal Referral
• Swelling may transilluminate Referral to a physician may be necessary if there
are signs of complications (e.g. if there is an
Differential Diagnosis associated inguinal hernia) or resolution does not
• Enlargement of groin node occur when expected (by 1 year of age).
• Inguinal hernia
• Trauma Surgical treatment is considered in the following
circumstances:
• Cystic lesion
• No signs of resolution by age 1 year
• Hematoma
• Hernias are associated with the hydrocele
• Neoplasm

September 2004 Hydrocele (Physiologic) - Pediatrics 1