UNILATERAL IDIOPATHIC HYDROCELE HAS A SIGNIFICANT EFFECT ON THE IPSILATERAL TESTICULAR GEOMETRY AND RESISTIVITY INDICES

Purpose: To determine whether idiopathic hydrocele effects the shape of ipsilateral testis and can be implicated as a cause of testicular ischemia. Methods and Materials: Group 1 consisted of 23 patients with unilateral idiopathic hydrocele whereas 30 healthy males constituted group 2. All patients underwent scrotal US by which testicular dimensions in craniocaudal (Dcc) and anteroposterior (Dap) axis were measured and Dcc/Dap ratio was calculated. By spectral Doppler analysis, resistivity indices of subcapsular and intratesticular arteries (RIsk, RIit) and RIsk/RIit ratio were determined. Results: Mean Dcc/Dap ratio for group 1 was 1.7±0.3(range,1.1–2.3), significantly lower than that for group 2 which was 1.9±0.3(range,1.3–2.2)(p=0.028). For ipsilateral testis in group1 and group 2, mean RIsk was 0.70±0.06(range,0.60–0.80) and 0.65±0.06(range,0.61–0.83) whereas mean RIit was 0.62±0.04 (range,0.56–0.72) and 0.59±0.06(range,0.51–0.74), respectively. Mean RIsk and RIit were significantly higher in group 1(p=0.006 and 0.021, respectively). Conclusions: Unilateral idiopathic hydrocele has a tendency for rounding rather than flattening the ipsilateral testis and elevating RIsk and RIit on the effected side. Since no spectral Doppler analysis criteria has been proposed for testicular ischemia yet, the impact of the difference for RIsk and RIit should arise the suspicion for ischemia. Further research is needed to elucidate any effect on spermatogenesis.