Fluid collections within the tunica vaginalis of the scrotum or along the spermatic cord.

May represent persistent developmental connections along the spermatic cord, or be due to an imbalance of fluid production and absorption.

Generally of little clinical significance.

Can lead to fluid accumulations that require surgery.

In patients with who have undergone varicocelectomy hydroceles may be of significance, as it insulates the testicle and can lead to infertility.

Patent processus vaginalis found in 80-90% of male infants at birth.

Frequency of patent vaginalis decreases to age 2 years and plateaus at 25-40%.

Autopsy of adult males associated with a frequency rate of a patent processus vaginalis of 20%.

Clinically apparent lesions seen in 6% of term males beyond the newborn period.

Increased incidence in breech presentation, gestational progestin use and low birth weight.

In children most cases are of the communicating type with leakage of peritoneal fluid from the patent processus vaginalis into the scrotum, and this is more prominent during the Valsalva movement.

In the U.S. the most common causes are iatrogenic for adults as a result of surgery within inadequate irrigation fluid aspiration in patients with patent processus vaginalis or a small hernia.

Worldwide this is most commonly due in adults to Wuchereria bancrofti parasitic infection, filariasis, with more than 120 million affected.

In noncommunicating lesions the balance between fluid production within the tunica and its absorption is altered.

Fluid accumulation in communicating lesions are from exogenous sources as the abdomen, while noncommunicating hydroceles the fluid in the scrotum results from scrotal fluid shifts.

With communicating hydroceles the Valsalva maneuver accounts for variation in scrotal size during day-sleep cycles.

In noncommunicating hydroceles fluid production may be increased or absorption may be impaired, as seen in viral mediated serositis, or posttraumatic hydroceles related to inflammation.

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