Hydrocele of the spermatic cord; Ultrasonographic findings

To evaluate the ultrasonographic findings of hydrocele of the spermatic cord. Ultrasonographic findings of twenty patients with surgically (n=7), clinically and ultrasonographically (n=13) proven hydrocele of the spermatic cord were retrospectively analyzed from April 1998 to February 2000. The location size, shape, thickness and regularity of the outer wall, and internal echo of the hydroceles were evaluated. Hydroceles were located on the left side in eleven cases and on the right side in nine cases. Fourteen of 20 hydroceles were situated superior to the testis while the remaining six cases were in the inguinal area. Shapes included oval (n=13) or elongated shape (n=7) with the tapered end toward the inguinal area. The thickness of walls of hydroceles was thin in all cases, but two of 20 hydroceles had irregular walls. Internal echo was anechoic in twelve cases while there were internal echoes in the remaining eight cases, showing septa like echoes in five cases, diffusely hypoechoic in two cases and debris with linear echoes in one case. All hydroceles showed separation from the testis and epididymis. In three cases, change in size during palpation was noted, but there was no ultrasonographic evidence of connection with the peritoneal cavity. There was one other case which showed change in size during ultrasonographic examination. Spermatic cord hydrocele can be effectively diagnosed by ultrasonography based on its specific location and shape. Furthermore, ultrasonography can be useful to exclude hernia, enlargement of the lymph node, or other solid masses.