Summary: Urological referral not normally indicated

Advice: Urological referral not normally indicated.
Refer To: Any adult urologist


Clinical information

Referral of asymptomatic hydroceles is actively discouraged, especially if “reassurance” is all that is needed; such referrals will no longer be accepted. Asymptomatic hydroceles require no treatment.

If there is doubt about diagnosis, ultrasound will clarify the nature of the problem. Ultrasound may also be helpful if the underlying testis is impalpable by demonstrating the internal architecture of the testis. If the testis or epididymis are abnormal on ultrasound, referral should be considered.

If ultrasound shows a secondary hydrocele due to an intra-testicular mass, “fast track” referral should be instituted to exclude a testicular tumour.

Aspiration alone is not recommended because of the high rate of recurrence and risk of infection.

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