The distal end of the processus vaginalis closes correctly, but the mid portion of the processus remains patent. The proximal end may be open or closed in this type of hydrocele. Morbidity may result from chronic infection after surgical repair. Hydrocele can adversely affect fertility. Chronic or secondary hydroceles usually occur in men older than 40 years.
Most hydroceles are asymptomatic or subclinical.
Evaluate the onset, duration, and severity of signs and symptoms. The usual presentation is a painless enlarged scrotum. The patient may report a sensation of heaviness or dragging. Patients occasionally report mild discomfort radiating along the inguinal area to the mid portion of the back. The size may decrease with recumbency or increase in the upright position.