Purpose or Case Report: This educational exhibit will present the importance and utility of utilizing ultrasound and various sonographic-imaging techniques to investigate and clarify the different types of pediatric hydroceles. It will convey the necessity for specifying the type of hydrocele in order to implement the best management protocols.
Methods & Materials: Hydroceles are one of the most common causes for young males to present with painless scrotal swelling. Persistence of the processus vaginalis results in a hydrocele. In rare instances female infants are born with a patent processus vaginalis, termed the canal of Nuck. Through this canal they can develop hydroceles and hernias similar to their male counterparts.

Representative sonographic cases will be used to demonstrate the various types of hydroceles, including simple testicular hydroceles, funicular and encysted spermatic cord hydroceles, as well as female canal of Nuck hydroceles. The cases presented will further demonstrate how various ultrasound techniques such as using supine versus upright positioning, application of probe pressure against the fluid collection and demonstration of color Doppler imaging, can elucidate the specific type of hydrocele. The importance of classifying hydroceles will be exemplified by brief commentary on urologic treatment for each variation of hydrocele.
Results: The exhibit displays the various sonographic techniques and the representative hydrocele images. The sonographic findings for each hydrocele is explained. Lastly, the importance of employing various sonographic methods to unveil the exact type of hydrocele is illustrated by correlation with the urologic treatment protocol.
Conclusions: Ultrasonography is a useful tool to utilize when diagnosing and classifying hydroceles. Various maneuvers like use of minimal compression, upright examination versus supine, as well as color Doppler imaging are employed for differentiating the types of hydroceles seen in both males and females. The importance of being able to describe the fluid collection and its route assists clinicians in determining treatment options. Truly understanding the specific type of hydrocele, can save some children from unnecessary surgical procedures.