Hydrocele in filarial and non filarial patients. Histopathological, histochemical and ultrastructural studies.

Twenty biopsied material of the testicular tissue were obtained from patients with unilateral hydrocele (eight due to lymphatic filariasis and twelve of idiopathic causes). Twenty biopsies lymphatic were also obtained from the normal unaffected testes and were used as control. The data obtained from histopathological, histochemical and ultrastructural studies revealed alternation in the testicular tissue with hydrocele than in the normal control testis. In the filarial hydrocele 37.5% of the cases showed thickening of the basement membrane and fibrosis with arrest of the spermatogenesis at the level of secondary spermatocytes. In addition, 12.5% showed thickening with interstitial fibrosis. Microfilariae were seen in hydrocele fluid of 3/8 cases (37.5%). In the idiopathic hydrocele 50% of the testicular tissue showed marked collagen deposits and testicular atrophy with fibrosis and thickening of basement membrane. The second 50% of cases showed variable degree of maturation arrests. Explanation for these variations in the pathological and anatomical pictures in both types of hydrocele is suggested. In the filariasis hydrocele it is due to the inflammatory response that may subside and recurrent. In the idiopathic hydrocele, it is due to the irreversible hypoxia caused by the continuous mechanical pressure due to huge amount of hydrocele fluid resulting in irreversible degenerative process with marked fibrosis.