CONGENITAL HYDROCELES

1. Congenital (complete) hydrocele: The funicular process is patent throughout but its neck is so narrow that
the bowel or omentum is not able to enter the sac. This occurs in malnourished children and tubercular ascites
should be suspected if condition is bilateral. The swelling increases on walking or standing for a long period
and disappear or reduces in size on recumbency.

2. Funicular hydrocele: This is an incomplete rare variety of congenital hydrocele. The funicular process is
closed just above the testis but continuous with peritoneal cavity. This rare condition may be confused with an
inguinal hernia.

3. Infantile hydrocele: It occurs in young individuals. The funicular process is obliterated at deep inguinal ring
but is continuous with tunica vaginalis.

4. Binocular hydrocele (en bisac): This is a very rare condition in which there are two inter-communicating
sacs – one above and the other below the neck of the scrotum. It presents as inguinoscrotal swelling with
positive cross fluctuation test.

5. Hydrocele of the hernial sac: This occurs due to collection of fluid in the hernial sac whose opening at the
deep inguinal ring is closed by the omental plug. History of inguinal hernia with separately palpable testis helps
to confirm this condition from infantile hydrocele.

6. Encysted hydrocele of the cord: This occurs when the funicular process is obliterated from the abdomen as
well as from tunica vaginalis and the intermediate portion is distended with fluid. It usually presents as a scrotal
swelling in relation to the spermatic cord. It is a smooth oval cystic and translucent swelling which is free from
testis. The traction test is positive.

7. Hydrocele of the canal of Nuck: This occurs in females and is comparable to the encysted hydrocele of the
cord. The cyst is in relation to round ligament. Unlike hydrocele of the cord it is wholly or partially in the
inguinal canal.