CHRONIC hydrocele of small or average size is painless. However, if of a large size, they could produce a dull ache or pulling sensation. When chronic hydrocele is tender or painful, other pathologic conditions of the epididymis, testicle, or both should be considered.
This is to report two cases in which extensive nodular smooth muscle proliferation of the thick hydrocele sac had extended on and into the parenchyma of the epididymis causing pain relieved only after surgical resection.
Materials and Methods
Twenty consecutive cases of hydroceles were reviewed. The age, history, physical findings, operative procedures, histologic sections, and clinic follow-ups were noted. There were only two patients among the group who had had painful hydrocele without evidence of inflammation or trauma of the scrotal region and with no evidence of disease elsewhere in the genitourinary tract.
—This 55-year-old white man was admitted to the hospital complaining of discomfort
Payan HM, Mendoza C, Ceraldi A. Diffuse Leiomyomatous Proliferation in the EpididymisA Cause of Pain in Hydrocele. Arch Surg. 1967;94(3):427-429. doi:10.1001/archsurg.1967.01330090121028