The resulting ischemia can cause testicular atrophy and subsequent impairment of fertility. Hemorrhage into the hydrocele can result from testicular trauma. Incarceration or strangulation of an associated hernia Surgical Complications Accidental injury to the vas deferens can occur during inguinal surgery for hydrocele. Postoperative hemorrhagic hydrocele is not uncommon, but usually resolves spontaneously. Direct injury to the spermatic vessels may occur.
Most congenital cases resolve by the end of the first year of life.
Persistent congenital hydrocele is readily corrected surgically. The prognosis of hydrocele presenting later in life depends upon the etiology of the hydrocele. Adult-onset hydrocele is not uncommonly associated with an underlying malignancy. In a patient with signs and symptoms of an acute scrotum, the presence of a hydrocele and a finding of positive transilluminance do not rule out a testicular torsion. Immediate definitive tests are indicated to rule out torsion, because testicular survival is poor after 4 hours of ischemia.