Epididymo-orchitis

Epididymal cysts

Epididymal cysts are the most common cause of scrotal swellings seen in primary care.

Features

• separate from the body of the testicle
• found posterior to the testicle

Associated conditions

• polycystic kidney disease
• cystic fibrosis
• von Hippel-Lindau syndrome

Diagnosis may be confirmed by ultrasound.

Management is usually supportive but surgical removal or sclerotherapy may be attempted for larger or symptomatic cysts.

Hydrocele

A hydrocele describes the accumulation of fluid within the tunica vaginalis. They can be divided into communicating and non-communicating:

• communicating: caused by patency of the processus vaginalis allowing peritoneal fluid to drain down into the scrotum. Communicating hydroceles are common in newborn males (clinically apparent in 5-10%) and usually resolve within the first few months of life
• non-communicating: caused by excessive fluid production within the tunica vaginalis

Hydroceles may develop secondary to:

• epididymo-orchitis
• testicular torsion
• testicular tumours