Incidental Testicular Pathologies in Patients With Idiopathic Hydrocele Testis: Is Preoperative Scrotal Ultrasound Justified?

Hydrocele testis is a common disease with a prevalence of 1% in adults. Although it can be diagnosed by physical examination, scrotal ultrasound represents a standard diagnostic tool, to exclude underlying pathologies among them testicular or scrotal malignancies.

We conducted a retrospective analysis of 156 patients aged between 20 and 60 years who underwent surgical hydrocelectomy between 2003 and 2018. Pre-surgical ultrasound, histological results, complications and patients' characteristics were analysed.

Malignancies were found in 0% of patients in the pre-surgical ultrasound. Interestingly, we found a higher incidence of hydrocele testis in patients with increasing age and 27% presented with symptoms other than painless enlargement of the scrotum. Among them recurrent pain was the most common. Surgical complications occurred in only 3.2%.

Testicular cancer is an important differential diagnosis of hydrocele testis. However, in our study no case of incidental testicular cancer or scrotal malignancy was found in the pre-surgical ultrasound.

Anticancer research. 2020 May [Epub]

Mona Kafka, Kilian Strohhacker, Friedrich Aigner, Fabian Steinkohl, Wolfgang Horninger, Renate Pichler, Isabel Heidegger

Department of Urology, Medical University Innsbruck, Innsbruck, Austria., Department of Radiology, Medical University Innsbruck, Innsbruck, Austria., Department of Urology, Medical University Innsbruck, Innsbruck, Austria .