Inguinal Hernia vs Hydrocele

How to differentiate between Inguinal hernia and hydrocele

Inguinal hernia is usually a reducible swelling which comes with cry or cough impulse. Whereas a hydrocele is a tense, cystic, clinically irreducible swelling without any impulse. Transillumination test is not reliable as it can be present in both the cases.

When one should operate for hernia in a child?

Inguinal hernias never go away without surgery. This is a condition in which surgery is advised to be done as early as possible as the risk of hernia getting obstructed is as high as 30 to 40% besides the risk of other complications like gut and testis necrosis.

Is surgery a must in hydrocele?

Unlike a hernia, there is no urgency in operating for a hydrocele. It can be safely observed till 18 months to 2 years of age as it is harmless provided it is not associated with inguinal hernia.

The hydrocele which are constant in size throughout the day time are usually scrotal type hydrocele and are seen in newborns. They are called as non- communicating hydroceles. It is this type of non -communicating hydrocele which tends to resolve spontaneously.

The hydrocele in which parents gives the history of increase and decrease in the size of swelling are called as communicating hydrocele and will eventually require surgery.