A collection of fluid connected with the testis (see TESTICLE) or spermatic cord. When there is no obvious cause, it is classified as primary: these generally present as a large, tense but painless scrotal swelling. Secondary hydrocoele is generally smaller and lax; it is usually secondary to a tumour or inflammation of the underlying testis or epididymis. Congenital hydrocoeles may occur in infants, when they are often associated with a hernial sac (see HERNIA).
Congenital hydrocoeles usually disappear spontaneously with surgery indicated only when there is a co-existing HERNIA or if the condition persists after the first year. Primary hydrocoeles in adults are generally managed by surgical removal or, for those awaiting or unfit for surgery, by ASPIRATION. Secondary hydrocoeles require treatment of the underlying condition.