Spermatic Cord Hydrocele: A Case Series.

Although hydrocele is one of the most common inguinoscrotal pathologies, spermatic cord hydrocele (SCH) is a rare entity. Its development is attributed to the incomplete closure of the processus vaginalis, resulting in a collection of fluid that may either communicate with or become encysted along the spermatic cord. Despite its rarity, it has been documented in children and, more rarely, in adults. As it presents with an inguinoscrotal swelling separate from the testis, the encysted variant of SCH poses a diagnostic dilemma when differentiating it from an irreducible inguinal hernia; however, its nature of being transilluminant, along with a complete clinical examination, aids in diagnosis. This study, conducted at a peripheral tertiary care center in northern India, aimed to describe the clinical presentation, diagnostic challenges, and surgical management of SCHs across different age groups, highlighting the importance of thorough clinical examination and ultrasonography in distinguishing this entity from inguinal hernia. We report six cases - two adult patients and four pediatric patients - with SCH, including five with the encysted variant and one with the communicating type, all of whom were managed surgically at our institute. The inclusion of both pediatric and adult cases makes this case series unique.