Sonographic Imaging of a Hydrocele of the Spermatic Cord

ABSTRACT

PURPOSE: The US examination has been used to evaluate the infant and child having an inguino-scrotal bulge or mass for the non-invasive diagnostic work up to exclude neoplasm, cryptorchidism, lymphadenopathy, hydrocele of spermatic cord, etc. We performed this study to determine the characteristic ultrasound features of hydrocele of spermatic cord in children. MATERIALS AND METHODS: From February 2002 to March 2007, 213 pediatric patients with swelling or palpable mass of the inguino-scrotal area, or suspected cryptorchidism underwent ultrasonography for evaluation of accurate diagnosis. Ninetythree of 213 patients had a cystic lesion of the inguino-scrotal area. Among 93 patients, the sonographic images of 28 patients, who were confirmed as having hydrocele of the spermatic cord, were collected on a retrospective basis. The age of the patients ranged from 15 days to 11 years. The ultrasound images of the patients were subsequently reviewed to analyze the typical features in the diagnostic workup of hydrocele of spermatic cord. Eight patients were confirmed by surgery. Twenty patients who were less than one year old were clinically followed up. RESULTS: The most common finding was testicular hydrocele, which was found in 44 patients of the 93 patients that had a cystic lesion of the inguino-scrotal area. Of the 28 patients who had a hydrocele of spermatic cord, 10 patients had the lesions on the left side and 17 patients on the right side. One patient has bilateral hydrocele of spermatic cord. Well-defined elongated or elliptical-shaped cystic lesions were noted in the 24 of 29 cases (one patient had bilateral hydrocele of the spermatic cord). One patient had septations within elongated cystic lesion was seen and round shape in one case; tear drop shape was found in three cases. CONCLUSIONS: The most common ultrasound imaging of spermatic cord hydrocele is well-defined, elongated cystic mass separating the testes.