Hydrocele of Spermatic Cord

  • Etiology: Aberrant closure of the processus vaginalis leading to patent processus vaginalis
  • Imaging US:
    — Encysted hydrocele (non-communicating hydrocele): Anechoic fluid collection in inguinal canal that does not communicate with peritoneal cavity above or tunica vaginalis and scrotum below
    — Funicular hydrocele (communicating hydrocele): Anechoic fluid collection in inguinal canal that communicates with peritoneal cavity above at internal inguinal ring but does not communicate with tunica vaginalis and scrotum below
  • DDX: Inguinal hernia
  • Complications:
  • Treatment: Surgical repair
  • Clinical: Occurs in males

Radiology Cases of Encysted Hydrocele of Spermatic Cord

US of encysted hydrocele of the spermatic cord
Sagittal US of the left scrotum shows a large anechoic mass in the left inguinal canal and upper scrotum that is superior to the left epididymis and testicle which are located on the right most aspect of the image. The mass did not communicate with the peritoneal cavity.
US of spermatic cord hydrocele
Sagittal US of the right inguinal canal and scrotum shows an oval anechoic fluid collection in the inguinal canal that did not communicate with the peritoneum (to the left) and a small amount of anechoic fluid around the right testicle.
US of encysted hydrocele of spermatic cord
Sagittal (above) US of the left groin shows an anechoic fluid collection in the left inguinal canal that does not communicate with the peritoneal cavity above or the scrotum below. Transverse US (below) better shows the septation within the fluid collection.

Radiology Cases of Funnicular Hydrocele of Spermatic Cord