This was a 42 year old man with left scrotal swelling , with history of pain on standing and lifting weights.

Clinically the surgeon felt that this could be varicocele. The patient had undergone repair surgery for left inguinal hernia few years ago.

The following images were obtained .

rt testis cc

LEFT TESTIS ; HYDROCELE SEEN

SEPTATED HYDROCELE WITHINTERNAL ECHOES SEEN

MULTI PLANAR VIEW OF SEPTATED HYDROCELE

3 D HIGH DEFINITION VIEW OF THE SAME

In general most surgeons do not refer patients for a scan when they are clinically very sure of hydrocele. In this patient the surgeon’s clinical impression was varicocele and so he wanted a scan .

The finding of hydrocele is helpful before surgery. But does the diagnosis of a septated hydrocele change anything for the surgeon ? 

When the fluid contains high protein or cholesterol content, the hydrocele may appear complex or septated. Hematoceles and pyoceles are complex hydroceles.  Sonographically, a simple hydrocele is seen as an anechoic dark fluid collection surrounding the testicle , whereas a complex hydrocele may contain internal echoes with septations and loculations.

Probably for the surgeon , there is no difference in dealing with a simple or complex hydrocele .