Sri Wulandari N., M.Kep., Ns.Sp.Kep.An.

Hydrocele

▪ The genitourinary conditions may affect the infant in the

first year of life
▪ A collection of peritoneal fluid that accumulates in the
scrotum through a small passage called the processus
vaginalis
▪ A hydrocele is a fluid collection within the tunica vaginalis
of the scrotum or along the spermatic cord
▪ This fluids collection may represent persistent
developmental connections along the spermatic cord or
an imbalance of fluid production versus absorption
 Pathophysiology
▪ The pathophysiology of hydroceles requires an imbalance of scrotal fluid
production and absorption, this imbalance can be devided further into
exogenous fluid sources on intrinsic fluid production
▪ Hidroceles can be devided into those that represent a persistent communication
with the abdominal cavity and those do not
Pathophysiology

▪ Fluid excesses are from exogenous sources (the abdomen) in

communicating hydroceles, whereas non communicating hydroceles
develop increased scrotal fluid from abnormal intrinsic scrotal fluid
shifts
▪ With communicating hydroceles, simple valsava maneuvers probably
account for the classic variation in size during day-sleep cycles
▪ Non communicating hydroceles may result from increased fluid
production or impaired fluid absorption
▪ Post traumatic hydroceles likely occur secondary to increased fluid
production due to underlying inflammation
Causes

▪ In children, most hydroceles are the communicating type, in which

patency of the processus vaginalis allows peritoneal fluid to flow into
the scrotum, particularly during valsava maneuvers.
Clinical Manifestations

▪ Palpable fullness.
Hydroceles typically manifest as a soft nontender fullness within the
hemiscrotum
▪ Transillumination.
When the scrotum is investigated with a focused beam of light, the
scrotum transilluminates, revealing a homogenous glow without
internal shadows
▪ Swelling
Surgical Management

▪ Inguinal
Ligation of the processus vaginalis high within the internal inguinal ring, the
procedure for pediatric hydroceles.
▪ Scrotal
With excision or eversion and suturing of the tunica vaginalis,
recommended for chronic noncommunicating hydroceles.
▪ Sclerotherapy
Scrotal aspiration and sclerotherapy of the hemiscrotum using tetracycline
or doxycycline solutions. Recurrence after sclerotherapy is common,
significant pain, epididymal obstruction.
Nursing Assessment

▪ Physical Examination
The scrotum is enlarged on both sides, a smooth, cystic feeling mass
completely surrounding the testicle and not involving the spermatic
cord.
Nursing Diagnoses

▪ Excess fluid volume/hypervolemia

▪ Acute pain
▪ Risk of infection
▪ Impaire urinary elimination
▪ Anxiety