Hydrocele results from the accumulation of fluid in the tunica vaginalis in the scrotal sac. It is a common condition, usually seen in adult males, that leads to painless enlargement of the scrotum. Chronic hydrocele has multiple etiologies and may occur secondary to other disorders like testicular malignancy or filarial infection. There is a high prevalence of chronic hydrocele, especially in filariasis endemic areas where Wuchereria bancrofti is the causative agent.
Filariasis is a mosquito-transmitted parasitic disease. Thus, filarial hydrocele is a late and chronic manifestation of filariasis. It is estimated that in endemic areas, over 40 million persons suffer from the chronic disfiguring manifestations of filariasis. These include filarial hydroceles (over 27 million males), lymph scrotum (chylocele), or elephantiasis of the scrotum. The genital pathology manifests most commonly as hydrocele and is due to blockage or dysfunction of the lymphatic vessels. A filarial hydrocele is not only debilitating but also has economic implications due to the huge numbers of affected adult males throughout the tropical and subtropical endemic regions and countries.
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