01 Nov 2017

Hydrocele disease commonly known as (scrotal swelling or mokabi in Setswana) cases are seen in Botswana health facilities around the country.

In an interview, a medical officer at Princess Marina Hospital, Dr Orapeleng Phuswane-Katse revealed that hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin layer surrounding a testicle.

She said it is common in newborns and usually disappears without treatment at the age of one year.

She said older boys and men could  develop a hydrocele due to inflammation or injury within the scrotum and usually it is not painful or harmful and might not need any treatment.

She however, said adult men with hydrocele might experience discomfort from the heaviness of a swollen scrotum and the pain generally increases with the size of the inflammation, which sometimes starts smaller in the morning and larger later in the day.   

On when to visit the health facility, Dr Phuswane-Katse said when one feels a weak point in the abdominal wall that allows a loop of intestine that extends into the scrotum called an inguinal hernia, or if there is sudden, severe scrotal pain or swelling, especially within several hours of an injury to the scrotum as signs and symptoms could occur with a number of conditions, including blocked blood flow in a twisted testicle (testicular torsion) he should seek immediate medical attention.

She said causes differ from age to age as in baby boys a hydrocele could develop before birth, and normally the testicles descend from the developing baby's abdominal cavity into the scrotum, a sac  accompanies each testicle, allowing fluid to surround the testicles and usually each sac closes and fluid is absorbed.

Dr Phuswane-Katse said sometimes, the fluid remains after the sac closes (non-communicating hydrocele ) and the fluid is usually absorbed gradually within the first year of life, but occasionally, the sac remains open (communicating hydrocele) and said the sac can change size or if the scrotal sac is compressed, fluid can flow back into the abdomen.

In older men she said a hydrocele can develop as a result of injury or inflammation within the scrotum, inflammation might be caused by an infection in the testicle or in the small, coiled tube at the back of each testicle (commonly known as epididymitis).

She said the risk factors of the hydroceles is that mostly they are present at birth and babies who are born prematurely have a higher risk of having a hydrocele.

On complications, she said a hydrocele typically is not dangerous and usually does not affect fertility, but might be associated with an underlying testicular condition that can cause serious complications which include infection or tumor, which might reduce sperm production of function and inguinal hernia.

This is when the loop of intestine trapped on the abdominal wall can lead to life threatening complications.

Dr Phuswane-Katse said diagnosis is normally made after performing a physical examination to check for tenderness and the size of the enlargement and to rule out an inguinal hernia and through blood and urine tests.

Regarding treatment she said a hydrocele that does not disappear on its own might need to be surgically removed. BOPA