ABSTRACT
Trauma, inflammation, or necrosis in the scrotal cavity may lead to depositing of organic material in hydrocele fluid with consecutive calcification if the fluid is oversaturated. During a period of 25 years, 2 scrotal calculi (calculous material in hydrocele fluid) in 2 of 42 patients (4.8%) were found during surgery on symptomatic hydroceles by the first author. In these symptomatic cases, infrared spectroscopy revealed carbonate apatite as the causative mineral. The appearance of scrotal calculi in hydrocele does not change the treatment or prognosis of hydroceles. However, if the calculous material is attached to the visceral or parietal part of the tunica vaginalis and does not change position during sonography with different postures, tumor growth may be a problem. An inguinal approach for operation should be chosen in such situations. Infrared spectroscopy can be used to determine the mineralogy of scrotal calculi. Carbonate apatite, the predominantly found mineral in scrotal calculi, can precipitate in an alkaline milieu.