Noncommunicating hydrocele results from pathologic closure of the processus vaginalis and trapping of peritoneal fluid. Adult-onset hydrocele may be secondary to orchitis or epididymitis. Hydrocele also can be caused by tuberculosis and by tropical infections such as filariasis. The clinician may be misled by focusing on the hydrocele, which delays the diagnosis of torsion. Tumor, especially germ cell tumors or tumors of the testicular adnexa may cause hydrocele.
Radiation therapy is associated with cases of hydrocele.
Exstrophy of the bladder may lead to hydrocele. Hydrocele may arise from Ehlers-Danlos syndrome. Hydrocele may result from a change in the type or volume of peritoneal fluid, like in patients undergoing peritoneal dialysis and those with a ventriculoperitoneal shunt. A CBC with differential may indicate the existence of an inflammatory process. Urinalysis may detect proteinuria or pyuria.