Hydrocele - Erler Zimmer 3D anatomy Series MP2109

This dissection model highlighting a Hydrocele is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical history.

A 40-year-old man presents with shortness of breath and swelling in his lower extremities. He is a smoker with a history of diabetes and previous myocardial infarctions. On examination of bilateral pleural effusion, peripheral edema pitting and swollen scrotum were observed. Transillumination of the swelling transmitted red light. Chest radiography showed the radiological features of congestive heart failure. He was started on appropriate treatment for heart failure, but later died during this hospitalization.

Pathology

The specimen is a testis and its covers, sliced to show the cut surface. The cavity bounded by the visceral and parietal layers of the tunica vaginalis is dilated due to the accumulation of serous fluid. This is an example of hydrocele, secondary to generalized edema due to congestive heart failure.

Further information

A hydrocele is an accumulation of serous fluid between the parietal and visceral layers of the tunica vaginalis around the testes. The hydrocele can be described as communicating with the peritoneal cavity or non-communicating with the peritoneal cavity.
Communicating hydroceles develop due to the failure of the processus vaginalis to close after the tests descend into the scrotum. These may occur after birth as a congenital hydrocele or may occur later in life due to increased intra-abdominal pressure, such as in this case heart failure. Noncommunicating hydroceles are caused by imbalances in fluid secretion and reabsorption, e.g., orchitis, epididymitis, testicular tumor, physical trauma (e.g., hernia, testicular torsion) or defective lymphatic drainage (e.g., filariasis, elephantiasis).

Patients present with a scrotal mass. The mass may be uni- or bilateral. Communicating hydrocele may be reducible and increase in size with increasing intra-abdominal pressure. Noncommunicating are generally nonreducible swellings. The swelling is usually not painful unless there is an underlying infection or torsion causing the hydrocele. Larger hydroceles can be bulky and cause erosion and infection of the skin on the scrotum. Diagnosis can be made on objective examination. Serous fluid allows shining light to pass through the scrotum when it is examined: this is called transillumination. Ultrasound can be used to consolidate the diagnosis and rule out other testicular pathologies. Serum markers of testicular cancer, such as alpha fetoprotein and B-HCG, can be taken to rule out testicular cancer.
Many congenital hydroceles resolve spontaneously before the age of 2 years. If the communicating hydrocele persists beyond 2 years of age, they are surgically repaired to reduce the risk of developing incarcerated hernias. Surgical repair of communicating hydrocele in older patients may be offered if they are symptomatic. Treatment of the underlying etiology of reactive hydrocele can cause its resolution.

What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient radiographic data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.