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Hydrocele of the canal of Nuck. Illustrated by Yiji Suh. Fig. 8. Giant hydrocele. Illustrated by Yiji Suh.
Source publication
Introduction:
A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma. It has distinct clinical manifestations, particularly discomfort and psychosocial distress. Understanding the anatomy, embryology, and physiology associated with hydrocele formation is cruci...
Citations
... They are generally treated with radical resection, as radiation and chemotherapy have proven ineffective [1]. Potential risk factors for this malignancy include asbestos exposure, chronic inflammation, trauma, and persistent hydrocele [1,2]. We present the case of a malignant epithelioid mesothelioma of the tunica vaginalis testis. ...
... Testicular mesotheliomas often present as a painless scrotal mass or hydrocele. A hydrocele is an accumulation of fluid within the tunica vaginalis between its parietal and visceral layers, often due to obstruction of outflow [2]. Hydroceles can be treated conservatively with aspiration, but they have a high rate of recurrence. ...
... These tumors are predominantly found in patients between the ages of 55 and 75. While their exact etiology is unknown, 2 Case Reports in Urology potential risk factors include asbestos exposure (reported in about a third of cases), chronic inflammation, persistent hydrocele, and testicular trauma [1,2]. A thorough review of our patient's medical records and personal accounts failed to reveal any known risk factors, including the absence of smoking, testicular trauma, or any known exposure to asbestos. ...
Mesotheliomas of the tunica vaginalis testis are rare malignant tumors that can present as a scrotal mass or hydrocele. These tumors are typically aggressive with high rates of recurrence and metastasis. Suspected risk factors for malignant mesothelioma include asbestos exposure, chronic inflammation, trauma, and persistent hydrocele. We report the case of a malignant epithelioid mesothelioma of the tunica vaginalis testis that presented as a finding at hydrocelectomy and was ultimately treated with radical inguinal orchiectomy. This patient was on chronic immunosuppression therapy with tacrolimus and mycophenolate mofetil secondary to a kidney transplant but had none of the common risk factors for mesothelioma formation. To our knowledge, this is the first case describing a possible connection between chronic immunosuppression and mesothelioma of the tunica vaginalis. However, future studies are needed to investigate this association and discern whether this could have played a role in our patient or if his mesothelioma formation was coincidental.
... Hydrocele is a common and bothersome condition in adults [1]. A recent Swedish study found an annual incidence of 60 per 100 000 [2], suggesting that there may be >100 000 new cases of hydroceles every year in the European Union alone. ...
Background
Although hydrocele is one of the most common urologic pathologies, it is seldom studied, and the major urologic associations have no guidelines for the management of adult hydroceles.
Objective
To characterize international practice variation in the treatment of adult hydroceles.
Design, setting, and participants
An international survey was conducted addressing the management of hydroceles among urologists in Belgium, Denmark, Finland, Iceland, Japan, and the Netherlands from September to December 2020. We invited a random sample of 170 urologists from each country (except Iceland).
Outcome measurements and statistical analysis
Urologists’ treatment options, factors relevant for decision-making, expected patient satisfaction, and outcomes after aspiration versus surgery were assessed.
Results and limitations
Of the 864 urologists contacted, 437 (51%) participated. Of the respondents, 202 (53%) performed both hydrocelectomies and aspiration, 147 (39%) performed hydrocelectomies only, and 30 (8%) performed aspiration only. In Belgium (83%), the Netherlands (75%), and Denmark (55%), urologists primarily performed hydrocelectomies only, whereas in Finland (84%), Japan (61%), and Iceland (91%), urologists performed both hydrocelectomies and aspiration. Urologists favored hydrocelectomy for large hydroceles (78.8% vs 37.5% for small), younger patients (66.0% for patients <50 yr vs 41.2% for ≥70 yr), patients with few or no comorbidities (62.3% vs 23.1% with multiple comorbidities), and patients without antithrombotic agents (53.5% vs 36.5% with antithrombotic agents). Most urologists considered patient satisfaction to be highest after hydrocelectomy (53.8% vs 9.9% after aspiration) despite believing that hydrocelectomy is more likely to cause complications (hematoma 77.8% vs 8.8% after aspiration). Estimates varied between countries.
Conclusions
We found a large variation in the treatment of adult hydroceles within and between countries. Optimization of hydrocele management globally will require future studies.
Patient summary
Our international survey shows that treatment of adult hydrocele varies considerably within and between countries.
... A pathological accumulation of serous fluid in the groin and pelvis caused by a variety of conditions, including illnesses or injuries, is known as gross hydrocele [1]. It is characterized by fluid accumulation in the tunica vaginalis, the sac that encloses the testis, which results in scrotal swelling [2]. ...
A gross hydrocele is caused by fluid accumulation within a layer wrapped around the testicle, called the
tunica vaginalis, derived from the peritoneum. A 65-year-old male complained of a non-tender, fluctuant
bulge in his right scrotum despite having a fully buried penis, a large hydrocele, and urinary retention. After
ultrasonography, the diagnosis was confirmed, and the patient underwent a successful surgical procedure
that included a hydrocelectomy and tunica vaginalis excision. The patient reported few postoperative
complications and a notable improvement in his quality of life. Surgery is a successful approach for treating
gross hydrocele, with minimal morbidity and excellent cosmetic outcomes.
... Although hydrocele typically causes little pain, it can have negative physical and psychological effects. [3,6] It is a rare condition brought on by the processus vaginalis' failure to shut during embryological development, which can result in hydrocele and inguinal hernia. [7] As a result, meticulous follow-up is crucial, and the best time for surgical intervention should be carefully assessed. ...
A hydrocele is a buildup of serous fluid in a body cavity. The English word
"hydrocele" is derived from the Greek words "hydro," which means "water," and
"kele," which means "tumour" (swelling). When transudate or watery (serous) fluid
accumulates excessively, the sac of tunica vaginalis becomes plugged. A hydrocele is
brought on by the fluid buildup in the bilayer tunica vaginalis. In both children and
adults, peritoneal fluid frequently accumulates because of the patent processus
vaginalis, which allows it to travel through the processus vaginalis into the scrotum
and surround the testicle. The bulk of studies on abdominal-scrotal hydrocele that
could be found all used the same definition: an abdominal hydrocele is when the
inguinoscrotal and abdominal chambers are in contact with one another. Hydrocele,
which is characterized by a buildup of fluid in the tunica vaginalis that causes the
scrotum to expand, is one of the chronic forms in men. There are 26.79 million cases of
hydrocele worldwide, with India accounting for 48% of those cases. This review study
discusses the etiopathogenesis, pathology, aetiology, risk factors, and combined
therapy (surgery) related to hydrocele.
... Hydrocele is a clinical condition resulting from fluid accumulation in the tunica vaginalis. In adults, primary hydrocele is mostly caused by a disturbed balance between fluid production and absorption within the tunica vaginalis itself [1]. It usually presents with slowly growing scrotal swelling and no diurnal size change, and on clinical examination, it shows transillumination of the examining torchlight. ...
... A contrast CT study showed retroperitoneal para-aortic lymphadenopathy about 6 cm in longitudinal dimension with mild right hydronephrosis ( Figure 1). 1 1 1 ...
Hydrocele is one of the most common causes of scrotal swellings. Fluid accumulation within the tunica vaginalis, a remnant of the peritoneum covering the testicle, leads to scrotal swelling. It is known to be a benign condition with no subsequent complications apart from increasing in size causing discomfort. Some patients could cope with the swelling effect and continue their life with no desire for further management while others are not fit for surgical intervention and would be treated conservatively with the same concept. However, once the testicle becomes swollen by the surrounding fluid, it would be difficult to examine the testicle itself even by an expert physician. We present here a 46-year-old patient who has been diagnosed with right hydrocele for a long time. The patient noticed general weakness and loss of weight. Initial investigations showed iron deficiency anemia and imaging showed retroperitoneal lymphadenopathy. Eventually, testicular ultrasonography showed a right testicular tumour that was masked by a hydrocele, resulting in delayed presentation of metastatic testicular cancer.
... A hydrocele is an accumulation of fluid in the scrotum between the two layers of the tunica vaginalis. In the form presented here, excessive fluid production occurred as a result either of ASFV-induced inflammation of the epididymis or testis, or generalized edema [16]. ...
African swine fever (ASF) is a severe, globally important disease in domestic and wild pigs. The testing of alternative transmission routes has proven that the ASF virus (ASFV) can be efficiently transmitted to sows via semen from infected boars through artificial insemination. Boars intramuscularly inoculated with the ASFV strain “Estonia 2014” showed grossly and microscopically visible changes in the testis, epididymis, prostate, and vesicular gland. The gross lesions included hemorrhages on the scrotum, testicular membranes, and parenchyma; edema; hydroceles; and proliferations of the tunica vaginalis. Histopathologically, vasculitis and perivasculitis was detected in the testis and epididymis. Subacutely infected animals further revealed a degeneration of the testicular and epididymal tubules, pointing to the destruction of the blood–testis and blood–epididymis barriers upon disease progression. This was confirmed by evidence of semen round cells and sperm abnormalities at later time points after the infection. The histopathology was associated with the presence of viral DNA and the infectious virus, and in a limited amount with viral antigens. In most scenarios, the impact of these changes on the reproductive performance and long-term persistence of the virus is probably negligible due to the culling of the animals. However, under backyard conditions and in wild boar populations, infected males will remain in the population and the long-term fate should be further evaluated.
... It contains an alcoholic volume of 35%-60% [11]. The Testes are the male gonads and are primarily the male reproductive organs [12]. They fulfill two functions, the production of gametes (sperm) and the secretion of hormones particularly the male hormone, testosterone [13]. ...
This study was designed to evaluate the cytohistomorphological and biochemical effect of alcoholic beverages on the prostate gland of adult male Wistar rats. Sixty-five (65) rats weighing between 180-230g were used for this experiment. They were randomly divided into 13 groups of five (5) animals each. Group 1 was the normal control. Group 2-13 were the experiment groups. Group 2, 3 and 4 were treated with 1.23mg/kg, 2.45mg/kg and 3.68mg/kg bodyweight of brandy respectively. Group 5, 6 and 7 were treated with 17.32mg/kg, 34.64mg/kg and 51.96mg/kg body weight of beer respectively. Group 8, 9 and 10 were treated with 12.25mg/kg, 24.96mg/kg and 36.74mg/kg bodyweight of soured wine respectively. Group 11, 12 and 13 were treated with 1.73mg/kg, 3.46mg/kg and 5.20mg/kg bodyweight of dry gin respectively. Administration was done daily for 28 days and orally using orogastric tube. On the 29th day, the animals were sacrificed using chloroform inhalation anaesthesia. The blood samples were aspirated via cardiac puncture and centrifuged for biochemical analysis, and testicular tissues were harvested, fixed in 10% buffered formalin, processed, and stained with haematoxylin and eosin. Body weight showed significant (p<0.05) increase in brandy administered groups compared to control. For testicular weight, there was an insignificant increase in all the treated groups except the group administered with 3.69mg/kg which showed insignificant decrease compared to control. Results for TT showed a general significant (p<0.001) decrease in all administered groups compared to control. FSH showed significant (p<0.05;0.01;0.001) decrease in group administered 3.69mg/kg of brandy, all administered groups of soured wine and group administered 5.20mg/kg of dry gin compared to control. Histology showed narrowed and elongated lumen of seminiferous tubule, hypertrophied sertoli cells, destroyed interstitial cells of leydig, distorted seminiferous tubules with degenerating spermatogenic cells in the administered groups compared to control. In conclusion, alcohol beverages pose adverse effects on the testes. KEYWORDS: Alcoholic Beverages, Testes, Histology, Testosterone, FSH.
... Usage and distribution for commercial purposes requires written permission. Rarely secondary hydroceles arise from local trauma, previous groin, or scrotal surgery or other rare causes [1][2][3][4][5]. Secondary hydroceles require only treatment if a patient is symptomatic and a simple resection of the hydrocele sac (hydrocelectomy) is permanently curative in 94-99% of all cases [6,7]. ...
... Tsai et al. [7], who described the largest cohort of patients who underwent different surgical techniques for hydrocele repair, demonstrated a similar recurrence rate of 6% as found in our study. Little is known about the etiology of recurrent hydroceles and inflammatory processes of the epididymis have been postulated to be partly responsible for the development, maintenance, and recurrence of hydroceles [4,5]. Therefore, we examined the histologic findings of epididymal specimens from the HRE group, which revealed chronic inflammation of the epididymis in 64% of patients. ...
Introduction:
Open hydrocelectomy via scrotal incision is the standard approach for secondary hydroceles. Traditionally, the Swiss urologic community offer hydrocelectomy with additional resection of the epididymis in elderly men with completed family planning. It is believed that the additional resection of the epididymis reduces the postoperative recurrence rate of hydroceles. However, there is no evidence supporting this theory. Therefore, the aim of this study was to compare the recurrence and complication rates for patients with secondary hydroceles undergoing either pure hydrocelectomy (puH) or hydrocelectomy with additional resection of the epididymis (HRE).
Materials and methods:
We reviewed all male patients who underwent surgical therapy for secondary hydroceles between May 2003 and February 2019 at our institution. Patient's baseline and perioperative characteristics as well as postoperative characteristics including complications and recurrence rates were gathered and compared between different surgical techniques.
Results:
A total of 234 patients were identified. puH was performed in 93 (40%) cases and HRE in 141 (60%) patients. Patients in the HRE group were older (median age: 62 vs. 38 years, p < 0.001), had a higher ASA-Score (p < 0.001), were more often on platelet aggregation inhibitors (19% vs. 7.5%, p = 0.01), and had a longer median operative time (75 vs. 64 min, p < 0.001). During a median follow-up of 46 months, a similar number of recurrent hydroceles were found for puH (7 [7.5%]) and HRE (6 [4.5%]) (p = 0.3). Complications were observed in 19 (20%) cases after puH compared to 25 (18%) cases after HRE (p = 0.6). Patients after puH experienced more often severe complications (Clavien-Dindo Grade 3b) compared to the HRE group (5 vs. 12%, p = 0.046).
Conclusion:
puH and HRE showed similar results in terms of overall low recurrence rates and also in terms of postoperative complications, even though patients who underwent puH experienced slightly higher severe complications. Both procedures are safe and effective, but it seems that HRE does not provide a relevant clinical benefit in comparison to puH for the management of men with secondary hydroceles.
... Surgical intervention is indicated when the mass causes pain or discomfort and interferes with function. 1 In this report, we present the case of a man who experienced a left hydrocele rupture that was spontaneous and atraumatic in nature. To our knowledge, there have been less than 10 case reports of ruptured hydroceles, and only two other reports of spontaneous, atraumatic rupture. ...
There is little information in the literature on the management and prognosis of ruptured hydroceles. We present a case report of spontaneous, atraumatic left hydrocele rupture in a 64-year-old male. His hydrocele was initially diagnosed as non-complex and appeared to have ruptured spontaneously three years after initial onset. On follow-up in clinic, mild re-accumulation of fluid was observed, and no pain was reported by the patient. Post-rupture fluid re-accumulation was minimal in our patient but there is potential for significant fluid re-accumulation based on other reports of ruptured hydroceles.
... This phenomenon in women was first reported by Coley in 1892 [25]. Similar to the male hydrocele, a female hydrocele probably arises due to an imbalance of secretion from and absorption of fluid by the secretory membranes of the canal of Nuck [3,26]. Although this imbalance is most frequently idiopathic, disturbed lymphatic drainage caused by trauma, infection or inflammation are other possible reasons [11,16]. ...
The cyst of the canal of Nuck is an extremely rare female hydrocele, usually occurring in children, but also in adult women. It is caused by pathology of the canal of Nuck, which is the female equivalent to the male processus vaginalis. Due to its rarity and the lack of awareness among physicians, the cyst of the canal of Nuck is a seldom-encountered entity in clinical practice and is commonly misdiagnosed. We report on a case of cyst of the canal of Nuck in a 42-year-old woman, who presented with a painful swelling at her right groin. In addition, we conducted a review of the current available literature. This review gives an overview of the anatomy, pathology, diagnostics, and treatment of the cyst of the canal of Nuck. The aim of this review is not only to give a survey, but also to raise awareness of the cyst of the canal of Nuck and serve as a reference for medical professionals.
