Epidemiology

Hydroceles predominantly occur in males and are rare in females. They are common in male infants and children and in many cases are associated with an indirect inguinal hernia.[5] Approximately 1% to 3% of full-term infants have a hydrocele or hernia.[6] Hydroceles are more prevalent in premature infants and in infants whose testes descend relatively late. Autopsy findings suggest patent processus vaginalis is present in 80% to 94% of infants and 15% to 30% of adults.[7][8][9][10] In the presence of a patent processus vaginalis, the incidence of a contralateral patent processus vaginalis has been found to be 15% to 22%.[11] In the majority of cases, the processus vaginalis closes within the first year of life and so the incidence of hydrocele decreases.[7][8][9][10] Intrauterine exposure to polybrominated biphenyl, a brominated flame retardant and endocrine disruptor, has been found to increase the risk of hydrocele/hernia.[12]

In boys presenting with a painless scrotal mass 15% to 50% have a hydrocele.[13][14]​​ The incidence in adult men is not known. Up to 20% of patients develop a hydrocele after varicocelectomy.[15]​ However, with some highly specialised microsurgical techniques, the occurrence rate may be decreased to less than 1%.[15][16][17]​​​ Approximately 10% of testicular malignancies are thought to present with hydroceles.[7] Filariasis is common in many countries worldwide and is often associated with hydroceles that occur as a result of lymphatic obstruction.[18]

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