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Hydrocele ?
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Hydrocele ?

  I am currently awaiting surgery for a hydrocele, (due 2/10/98) at my local hospital. My right testicle is very swollen, a hydrocele is diagnosed. I am worried that everything I have read about a hydrocele indicates this it is painless, yet this is not the case.  My grion area is painful and on examination I can feel the tubes which lead down to the testicles seem to be the origin, the area directly above, ie the right hand side of the base of the penis and the testicle aches.
  Briefly, I have had three visits to Hospital, the first doc diagnosd hydrocele, in the second I had an ultrasound scan, this seemed to confirm the hydrocele but in the centre of the right testical a small white fleck was noticed.  On the third visit another doc talked about this fleck and said it might be something similar to chalk / garphite and to-check in 6 months. Unfortuately we did'nt discuss the hydrocele to any great extent.
  Please - Why is my hydrocele painful ? What might happen with this fleck?
  Many thanks Derek
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Dear Derek,
It is not uncommon for a patient to have pain with a hydrocele.  In fact that is one of the indications to operate on a patient with a hydrocele.  A hydrocele is simply a fluid collection in the sac (Tunica Vaginalis)surrounding the testicle.  It consists of fluid that is not reabsorbed by the body.  Most hydroceles grow to a certain size and then stabilize.  They are acutely caused by local injury, radiotherapy, acute nonspecific or Tuberculous epididymitis, or orchitis.  It could even occur secondary to a neoplasm.
A chronic hydrocele is more common, it usually occurs in men past the age of 40.  A very tense hydrocele can decrease the circulation to the testicle and cause atrophy(shrinking) and pain.  This later type of hydrocele is more likely your problem.
Your ultrasound result is difficult for me to assess because I cannot see the film.  A white fleck or hyperechoic area could be a number of different things.  As long as the testicle could be visualized with good flow and no evidence of any masses, more that not the testicle should be fine.
The only indications for an operation are pain, infection, disabling size, compromised flow to the testicle or cosmetic purposes.  Otherwise a stabilized hydrocele will not cause you a problem.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

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