DISTINCTIVE FEATURES OF HYDROCELE DIAGNOSTICS IN ADULTS AND CHILDREN: CLINICAL, IMAGING AND PATHOPHYSIOLOGICAL PERSPECTIVES

Hydrocele represents one of the most frequent benign scrotal conditions encountered in both pediatric and adult urological practice. Despite its generally favorable prognosis, accurate diagnosis remains essential to exclude underlying pathology, particularly in adults where secondary causes such as infection, trauma, or malignancy may coexist. The diagnostic approach to hydrocele differs significantly between children and adults due to variations in etiology, anatomical development, and associated risk factors. In pediatric populations, hydrocele is predominantly congenital, resulting from incomplete closure of the processus vaginalis, with reported prevalence rates of up to 5% in full-term male neonates. In contrast, adult hydrocele is commonly acquired and affects approximately 1% of adult males, with increasing incidence after the age of 40. This article provides a comprehensive scientific analysis of diagnostic strategies in both age groups, emphasizing clinical examination, transillumination testing, ultrasonography, and differential diagnosis. Statistical data from contemporary epidemiological studies are integrated to demonstrate prevalence patterns and diagnostic accuracy. The paper further explores theoretical models explaining fluid accumulation mechanisms and discusses the sensitivity and specificity of imaging modalities. Distinguishing congenital communicating hydrocele from non-communicating and secondary hydrocele forms remains central to effective clinical management. A structured evaluation algorithm is proposed to optimize diagnostic precision while minimizing unnecessary interventions. The findings underscore the importance of age-specific diagnostic criteria in ensuring accurate identification and appropriate therapeutic decision-making.