A Comprehensive History of Hydrocoele: From Ancient Descriptions to Modern Urological Practice

Introduction: Defining the "Water Tumour"

The term "hydrocoele," a condition recognized since the dawn of recorded medicine, carries its history within its very name. Its etymology traces back to Ancient Greek, where ὑδροκήλη (hudrokḗlē) is a direct and descriptive compound of ὕδωρ (húdōr), meaning "water," and κήλη (kḗlē), meaning "tumour" or "swelling".¹ This ancient designation, reflecting a purely observational understanding of a scrotal swelling filled with fluid, entered the English lexicon around 1597, having passed through Latin (

hydrocēlē) and French (hydrocèle).⁴ The alternative spelling, "hydrocoele," is a hypercorrect variant found predominantly in British English.⁶ The journey from this simple, descriptive name to our current, mechanistic understanding encapsulates the entire history of medical progress.

Today, a hydrocoele is defined with anatomical precision as an abnormal collection of serous fluid between the parietal and visceral layers of the tunica vaginalis, the thin membrane that surrounds the testicle.⁷ This modern definition is rooted in a deep comprehension of embryology and anatomy. The key structure is the processus vaginalis (PV), an outpouching of the abdominal lining (peritoneum) that accompanies the testes as they descend into the scrotum during fetal development.⁷ Normally, this channel closes off, or obliterates, before or shortly after birth. When it fails to close completely, it leaves an open connection between the abdomen and the scrotum, allowing peritoneal fluid to collect around the testicle. This is known as a congenital or communicating hydrocoele.⁷ The distal portion of this channel that remains around the testis is called the tunica vaginalis (TV), a potential space. Even after the PV has closed, an imbalance between the fluid secreted and absorbed by the tunica vaginalis can lead to a fluid buildup, known as an acquired or non-communicating hydrocoele.⁷

This report will chart the historical journey of understanding and treating the hydrocoele. It will trace the evolution of knowledge from a simple external observation of a "water tumour" to a nuanced comprehension of its developmental, anatomical, and even molecular underpinnings. Furthermore, it will explore how this evolving scientific knowledge, propelled by major revolutions in medicine, has continuously transformed its management from primitive interventions to sophisticated modern therapies.

Early Recognition and Ancient Interventions (Antiquity – c. 1500 CE)

The recognition of abnormal scrotal swelling is as old as medicine itself. While specific terminology is often lost to time, evidence from ancient civilizations indicates a long-standing familiarity with the condition.

Ancient Egypt and the Greco-Roman World

In ancient Egyptian medical texts and artistic depictions, individuals are shown with scrotal protuberances consistent with conditions like hydrocoeles and hernias, establishing their presence as recognized clinical entities in antiquity.¹² Later, in the Greco-Roman world, physicians like Aulus Cornelius Celsus (c. 25 BCE – 50 CE) provided detailed descriptions of various scrotal pathologies in his seminal work

De Medicina.¹² However, the most critical contribution from this era was anatomical. Galen of Pergamon (129 – c. 216 CE) is credited with the first anatomical description of the tunica vaginalis, the specific membranous sac that envelops the testis.¹⁵ Though his understanding was incomplete, Galen's identification of this distinct layer was a foundational step toward pinpointing precisely where the fluid in a hydrocoele accumulates.

Ancient India: The Sushruta Samhita

One of the earliest and most remarkably precise clinical accounts of a hydrocoele comes from ancient India. The Sushruta Samhita, a foundational text of Ayurvedic medicine dating to approximately 600 BCE, describes a condition called Mutraja-vriddhi (scrotal enlargement due to fluid).¹⁶ The text’s diagnostic description is strikingly accurate, noting a swelling that is soft and fluctuates "like a skin-bladder filled with water".¹⁶ More significantly, the

Samhita recommends a specific surgical intervention: Vyadhana, which translates to puncturing or drainage.¹⁹ This represents the earliest known documented interventional treatment for a hydrocoele, establishing the therapeutic principle of drainage that would remain a primary approach for more than two millennia.

The contrast between the medical philosophies of ancient India and the subsequent Greco-Roman and Medieval European traditions is stark. The Sushruta Samhita identified a localized, anatomical problem—excess fluid in a sac—and proposed a direct, mechanical solution: puncture and drain it. Conversely, Western medicine, heavily influenced by Hippocratic and Galenic theories, was dominated by the concept of the four humors (blood, phlegm, yellow bile, and black bile).²⁰ From this perspective, a scrotal swelling would not be seen as a localized fluid issue but as a systemic imbalance, perhaps an excess of phlegm. The logical treatment for such a humoral imbalance was systemic—bloodletting, dietary changes, purging—rather than local surgery.²¹ This philosophical framework actively discouraged the kind of direct intervention described by Sushruta. Consequently, the advancement of hydrocoele treatment in the West stagnated for centuries, not from a lack of observation, but from an overarching theoretical model of disease that prioritized systemic balance over direct anatomical correction.

The Surgical Renaissance and the Dawn of Anatomy (c. 1500 – 1800)

The European Renaissance sparked a renewed interest in human anatomy, moving medicine away from purely theoretical models and toward empirical observation. The meticulous dissections performed by anatomists like Andreas Vesalius in the 16th century provided the first truly detailed maps of the human body. This newfound anatomical clarity was essential for surgeons to begin reliably distinguishing between a hydrocoele (a sac of fluid) and an inguinal hernia (a protrusion of abdominal contents), a critical diagnostic step.

During this period, the French surgeon Ambroise Paré (1510-1590) championed a new philosophy of surgery. He famously advocated for a "gentle art," rejecting brutal traditional methods like cauterizing wounds with boiling oil in favor of using ligatures to control bleeding and applying soothing balms to promote healing.¹³ While not specifically mentioning hydrocoeles, Paré's emphasis on minimizing tissue damage and his recognition that pediatric hernias were likely congenital laid the intellectual groundwork for more considered and less destructive surgical approaches.²³

It was in the 18th century that surgeons began to seek a definitive cure for hydrocoele beyond simple, recurrent drainage. The English surgeon Percivall Pott (1714-1788) was a leading figure in this effort, writing extensively on the topic.²⁴ In a 1772 publication, he described a method for achieving a "perfect or radical cure" by means of a seton.²⁶ A seton is a cord or thread passed through the tissue and left in place to create a channel for drainage and, more importantly, to induce a chronic inflammatory response. Pott's intention was that this inflammation would cause the walls of the tunica vaginalis to scar together, thereby obliterating the fluid-secreting sac. While crude by modern standards and carrying a high risk of infection, Pott's method was a monumental conceptual leap. It was the first systematic attempt to permanently alter the underlying pathology and prevent fluid reaccumulation, marking the beginning of the search for a lasting surgical solution.

The 19th Century Transformation: Anesthesia, Antisepsis, and Anatomy

The 19th century witnessed a trio of scientific revolutions that collectively created the foundation for modern surgery, transforming the treatment of hydrocoele from a perilous ordeal into a safe and effective procedure. By this time, the detailed anatomy of the inguinal region and the embryological development of the processus vaginalis were well understood, providing surgeons with a clear map of the pathology they needed to correct.¹⁵

The Anesthetic and Antiseptic Revolutions

The public demonstration of ether anesthesia in 1846 by William T.G. Morton fundamentally changed the nature of surgery.²⁷ Before this, operations were brutal, hurried affairs limited by the patient's ability to endure unimaginable pain. Anesthesia removed this constraint, allowing surgeons to replace rapid, often imprecise actions—like a quick puncture of a hydrocoele—with slow, deliberate, and meticulous anatomical dissection.²⁹ For the first time, a surgeon could take the necessary time to carefully incise the scrotum, identify the layers of the tunica vaginalis, drain the fluid, and attempt a proper repair of the sac itself.

However, anesthesia alone was not enough. The longer operating times it permitted also meant longer exposure of deep tissues to the bacteria-laden environment of the 19th-century operating theatre. Post-operative infection, or sepsis, was rampant, with mortality rates for major operations hovering near 40-50%.³¹ The common report was "operation successful, but the patient died." This changed with the work of Joseph Lister, a British surgeon who, inspired by Louis Pasteur's germ theory, developed the principles of antiseptic surgery in the 1860s.³¹ Lister introduced the use of carbolic acid to sterilize surgical instruments, the patient's skin, the surgeon's hands, and even the air via a vaporizing spray.³³

These two innovations were not merely parallel but synergistically essential. Anesthesia created the opportunity for precision but simultaneously introduced the new and often fatal risk of prolonged exposure to pathogens. Antisepsis directly mitigated this new risk, making it safe for surgeons to utilize the time that anesthesia provided. Together, they unlocked the potential for modern anatomical surgery. A hydrocelectomy could now be performed not only without pain but with a reasonable expectation of survival, paving the way for the development of refined surgical techniques.

The Modern Surgical Era (20th Century)

Building on the 19th-century foundations of anatomy, anesthesia, and antisepsis, the 20th century became an era of technical refinement and diagnostic certainty in the management of hydrocoeles. Surgeons developed standardized, reliable operations that remain the gold standard today.

Eponymous Surgical Techniques

For treating adult (non-communicating) hydrocoeles, two principal open surgical techniques emerged, named after their developers:

• The Jaboulay Procedure (c. 1902): Described by the French surgeon Mathieu Jaboulay, this technique involves making a scrotal incision, draining the fluid, and then excising the redundant portion of the tunica vaginalis sac. The remaining edges of the sac are then turned inside out (everted) and sutured together behind the testis and spermatic cord.¹¹ This prevents the cut edges from sealing and re-forming a fluid-collecting space. The Jaboulay procedure is particularly well-suited for large hydrocoeles or those with thickened, chronic sacs.¹¹
• The Lord's Procedure (1964): Developed by British surgeon P. H. Lord, this technique was designed to be less invasive and "bloodless".³⁸ After a small scrotal incision and drainage of the fluid, the tunica vaginalis sac is not excised but is instead gathered and bunched up with a series of sutures, much like a drawstring bag. This process, known as plication, obliterates the potential space without extensive tissue dissection.¹¹ The Lord's procedure is generally preferred for small-to-medium sized hydrocoeles with thin walls, as it carries a lower risk of postoperative bleeding and hematoma formation compared to the Jaboulay technique.¹¹

It is crucial to note that the surgical approach for congenital (communicating) hydrocoeles in children is fundamentally different. The objective is not merely to manage the fluid in the scrotum but to correct the underlying anatomical defect: the patent processus vaginalis. Therefore, the standard procedure involves a small incision in the groin (inguinal region), through which the surgeon identifies and ligates (ties off) the connection to the abdominal cavity, permanently closing the channel.⁴⁰

The Diagnostic Revolution: Scrotal Ultrasonography

The latter half of the 20th century also brought a paradigm shift in diagnosis with the advent of high-resolution scrotal ultrasonography.⁴³ Before ultrasound, the primary diagnostic method was transillumination—shining a bright light through the scrotum. If the light passed through, indicating a fluid-filled structure, a hydrocoele was presumed.⁸ While useful, this method was not definitive.

Ultrasound provided a non-invasive, safe, and highly accurate way to visualize the scrotal contents. A simple hydrocoele appears as a clear, anechoic (black) fluid collection surrounding the testis.⁷ Most importantly, ultrasound allows for detailed examination of the testis and epididymis themselves. This enables clinicians to confidently rule out other, more serious causes of scrotal swelling that do not transilluminate well, such as testicular tumors, epididymitis (inflammation), or complex cysts.¹¹ The certainty provided by ultrasound made it the undisputed gold standard for diagnosis, ensuring that patients received the correct diagnosis and that underlying pathologies were not missed.

Contemporary Practice and Future Horizons (21st Century)

Current management of hydrocoeles is characterized by a nuanced, patient-specific approach that balances conservative observation with a range of minimally invasive and non-surgical options.

Current Standards of Care

The cornerstone of modern practice is the recognition that not all hydrocoeles require intervention. For newborns, the vast majority of congenital hydrocoeles are known to resolve spontaneously as the processus vaginalis closes and the trapped fluid is absorbed by the body. Therefore, the standard approach is "watchful waiting" for the first 12 to 18 months of life.⁴⁹ Similarly, in adults, small, asymptomatic hydrocoeles that do not cause discomfort or cosmetic concern are often managed conservatively with observation alone.⁴⁵

When intervention is necessary, the trend is toward less invasive techniques. For children with persistent communicating hydrocoeles, laparoscopic surgery has emerged as an alternative to the traditional open groin incision. This approach involves inserting a small camera and instruments through tiny abdominal incisions to ligate the patent processus vaginalis from within, offering excellent visualization and the ability to check the opposite side for a potential hernia or hydrocoele.⁹

Non-Surgical Alternatives for Adults

For adult men who are poor candidates for surgery or who wish to avoid general anesthesia, a modern refinement of the ancient drainage technique has become a viable option: aspiration and sclerotherapy. This office-based procedure involves two steps. First, the fluid is drained from the hydrocoele sac using a needle (aspiration). Second, a sclerosing agent—a chemical irritant such as doxycycline, phenol, or sodium tetradecyl sulfate—is injected into the empty sac.⁵³ This agent induces an inflammatory reaction that causes the walls of the tunica vaginalis to scar together, obliterating the potential space and preventing fluid from reaccumulating.⁵⁵ While the risk of recurrence is higher than with surgery, success rates are favorable, often reaching 80-85%, making it an effective and minimally invasive alternative for select patients.⁵⁴

Frontiers of Research

The understanding of hydrocoele is now progressing from the anatomical to the molecular level. Pioneering research has begun to investigate the underlying mechanisms of fluid transport within the tunica vaginalis. For instance, studies have identified an overexpression of specific water-channel proteins, known as aquaporin-1 (AQP1), in the membranes of cells lining the tunica vaginalis in patients with non-communicating hydrocoeles.⁵⁷ This suggests that an abnormality in these microscopic channels could be a key factor in the imbalance between fluid secretion and absorption that causes the condition. This line of inquiry could one day lead to pharmacological treatments that target these channels, potentially offering a non-invasive cure. Looking further ahead, emerging fields like stem cell therapy and tissue engineering hold theoretical promise for regenerative approaches to repair damaged lymphatic drainage or other underlying causes of hydrocele formation.⁵³

Conclusion: An Evolving Understanding

The history of the hydrocoele is a remarkable journey through the annals of medicine. It begins with a simple, descriptive name—the "water tumour"—coined in antiquity based on pure observation. For millennia, treatment was limited to the equally simple act of drainage, a temporary solution first documented by Sushruta in ancient India. The Renaissance and the age of anatomy provided the first crucial insight, identifying the specific sac—the tunica vaginalis—where the fluid collected.

However, the true birth of modern treatment required the 19th-century triad of scientific breakthroughs. A detailed understanding of anatomy and embryology provided the map, the advent of anesthesia removed the barrier of pain, and the principles of antisepsis conquered the lethal threat of infection. This powerful combination transformed hydrocelectomy from a brutal, high-risk procedure into a safe, deliberate, and effective operation.

The 20th century refined this foundation, standardizing the elegant surgical techniques of Jaboulay and Lord and providing diagnostic certainty with the advent of ultrasound. Today, in the 21st century, the focus has shifted to nuance and patient choice, with an emphasis on conservative management, minimally invasive surgery, and effective non-surgical alternatives like sclerotherapy. As research delves into the molecular mechanisms of fluid transport, the story continues to evolve. The history of the hydrocoele is, therefore, a microcosm of the history of medicine itself—a compelling narrative of how scientific inquiry, technological innovation, and a persistent desire to heal have transformed a common human affliction from an enigmatic swelling into a thoroughly understood and highly manageable condition.

Visual Timeline of Hydrocoele Research and Treatment

References

1. Mayo Clinic. (2023, January 12). Hydrocele - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/hydrocele/symptoms-causes/syc-20363969
2. Leslie, S. W., Sajjad, H., & Siref, L. E. (2023). Hydrocele. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559125/
3. Advocate Health. (n.d.). Hydroceles. Retrieved from https://www.advocatehealth.com/health-services/urology/hydroceles
4. ColumbiaDoctors. (n.d.). Hydrocele. Retrieved from https://www.columbiadoctors.org/health-library/condition/hydrocele/
5. BMJ Best Practice. (2023, October 20). Hydrocele. https://bestpractice.bmj.com/topics/en-us/1104
6. Children's Health of Orange County (CHOC). (n.d.). Hydrocele. Retrieved from https://choc.org/conditions/urology/hydrocele/
7. Boston Children's Hospital. (n.d.). Hydrocele. Retrieved from https://www.childrenshospital.org/conditions/hydrocele
8. Dagur, G., Gandhi, J., Suh, Y., Weissbart, S., Sheynkin, Y., Smith, N. L., Joshi, G., & Khan, S. A. (2017). Classifying hydroceles of the pelvis and groin: An overview of etiology, secondary complications, evaluation, and management. Current Urology, 10(1), 1–14. https://doi.org/10.1159/000447145
9. Aurora Health Care. (n.d.). Hydroceles. Retrieved from https://www.aurorahealthcare.org/services/urology/hydroceles
10. Stanford Medicine Children's Health. (n.d.). Hydrocele in Children. Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=hydrocele-in-children-90-P03090
11. Wikipedia. (n.d.). Hydrocele. Retrieved from https://en.wikipedia.org/wiki/Hydrocele
12. Mount Sinai Health System. (n.d.). Hydrocele. Retrieved from https://www.mountsinai.org/health-library/diseases-conditions/hydrocele
13. The Urology Group. (n.d.). Hydrocele. Retrieved from https://www.urologygroupvirginia.com/urologic-care/testicular-scrotal-disorders/hydrocele
14. Nationwide Children's Hospital. (n.d.). Hydrocele. Retrieved from https://www.nationwidechildrens.org/conditions/hydrocele
15. Oakley, E., & Alhasso, A. (n.d.). Hydrocele. TeachMePaediatrics. Retrieved from https://teachmepaediatrics.com/surgery/urology/hydrocele/
16. Wiktionary. (n.d.). hydrocele. Retrieved from https://en.wiktionary.org/wiki/hydrocele
17. Merriam-Webster. (n.d.). Hydrocele. In Merriam-Webster.com dictionary. Retrieved from https://www.merriam-webster.com/dictionary/hydrocele
18. Wiktionary. (n.d.). hydrocoele. Retrieved from https://en.wiktionary.org/wiki/hydrocoele
19. Oxford English Dictionary. (n.d.). hydrocele, n. Retrieved from https://www.oed.com/dictionary/hydrocele_n
20. Mayo Clinic. (2023, January 12). Hydrocele - Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/hydrocele/diagnosis-treatment/drc-20363971
21. PulseNotes. (n.d.). Hydrocele. Retrieved from https://app.pulsenotes.com/surgery/urology/notes/hydrocele
22. Wikipedia. (n.d.). Hydrocele testis. Retrieved from https://en.wikipedia.org/wiki/Hydrocele_testis
23. Radiopaedia. (n.d.). Hydrocele. Retrieved from https://radiopaedia.org/articles/hydrocele-2
24. Perth Children's Hospital. (n.d.). Hydrocele. Retrieved from https://pch.health.wa.gov.au/For-health-professionals/Referrals-to-PCH/Prereferral-guidelines/Hydrocele
25. Singh, S., & Waseem, M. (2020). Hydrocele. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/32644551/
26. Kumar, P., Kumar, P., Kumar, A., Kumar, A., Kumar, P., & Kumar, R. (2023). Brief summary: Hydrocele and current therapy options. International Journal of Medical and Pharmaceutical Research, 7(10), 47-57.
27. Cleveland Clinic. (n.d.). Hydrocelectomy. Retrieved from https://my.clevelandclinic.org/health/procedures/16232-hydrocelectomy
28. Fasana, F., & Walji, A. H. (1983). History of Hydrocele. In The Hydrocele. CRC Press. https://www.taylorfrancis.com/chapters/mono/10.1201/9780429280962-1/history-hydrocele-fortunato-fasana-walji
29. Marte, A., Pintozzi, L., Cavaiuolo, S., & Parmeggiani, P. (2018). The history of varicocele: from antiquity to the modern ERA. International Brazilian Journal of Urology, 44(3), 563–576. https://doi.org/10.1590/S1677-5538.IBJU.2017.0222
30. Wisdom Lib. (n.d.). Chapter XII - Diagnosis of hernia, tumours, elephantiasis, etc. In Sushruta Samhita, volume 2, Nidanasthana. Retrieved from https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-2-nidanasthana/d/doc142870.html
31. Wikipedia. (n.d.). Sushruta Samhita. Retrieved from https://en.wikipedia.org/wiki/Sushruta_Samhita
32. Das, S. (2009). Urology in ancient India. Indian Journal of Urology, 25(1), 2–5. https://doi.org/10.4103/0970-1591.45505
33. Anjum, R., & V, S. (n.d.). Surgical procedures in sushruta samhita and its relevance in modern surgery. AYUSHDHARA.
34. Sharma, P., Singh, H., & Singh, V. (2024). Sushruta: The Father of Surgery and Ancient Medical Innovations. Cureus, 16(5), e60814. https://doi.org/10.7759/cureus.60814
35. Patil, S. S., & Kamble, P. S. (2023). A Review on concept of Mutravruddhi. Asian Journal of Pharmaceutical Research and Development, 11(3), 62-64.
36. Johns Hopkins Medicine. (n.d.). Hydrocele Repair. Retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hydrocele-repair
37. LITFL. (n.d.). Percivall Pott. Retrieved from https://litfl.com/percivall-pott/
38. Chaudhari, A. K., Patil, J. U., Phalak, M. O., & Chaudhari, T. (2024). Sir Percivall Pott: A Stalwart Contributor to the World of Surgery. Cureus, 16(6), e62900. https://doi.org/10.7759/cureus.62900
39. Wellcome Collection. (n.d.). An account of the method of obtaining a perfect or radical cure of the hydrocele, or watry [sic] rupture, by means of a seton / [Percivall Pott]. Retrieved from https://wellcomecollection.org/works/d29dy6xn/items?canvas=26
40. Embryo Project Encyclopedia. (n.d.). Percivall Pott (1714-1788). Retrieved from https://embryo.asu.edu/pages/percivall-pott-1714-1788
41. Wikipedia. (n.d.). Percivall Pott. Retrieved from https://en.wikipedia.org/wiki/Percivall_Pott
42. Circulating Now from the NLM Historical Collections. (2014, January 6). Percivall Pott: Orthopedics and Occupational Health. https://circulatingnow.nlm.nih.gov/2014/01/06/percivall-pott-orthopedics-and-occupational-health/
43. El-Gohary, M. A. (2017). Pediatric Hydrocele: A Comprehensive Review. Clinics in Surgery, 2, 1422.
44. Wikipedia. (n.d.). History of general anesthesia. Retrieved from https://en.wikipedia.org/wiki/History_of_general_anesthesia
45. European Society of Anaesthesiology and Intensive Care. (n.d.). A Short History of Anaesthesia Before 1846. Retrieved from https://esaic.org/a-short-history-of-anaesthesia-before-1846/
46. University of Medicine and Health Sciences. (2015, November 11). Medical Milestones: Discovery of Anesthesia & Timeline. https://www.umhs-sk.org/blog/medical-milestones-discovery-anesthesia-timeline
47. Sarasota Memorial Health Care System. (n.d.). A Brief History of Anesthesiology. Retrieved from https://www.smh.com/blog/a-brief-history-of-anesthesiology
48. World Federation of Societies of Anaesthesiologists. (n.d.). History of Anaesthesia. Retrieved from https://wfsahq.org/about/history/history-of-anaesthesia/
49. The Royal College of Anaesthetists. (n.d.). The History of Anaesthesia. Retrieved from https://www.rcoa.ac.uk/about-us/heritage/history-anaesthesia
50. Dittrick Medical History Center. (n.d.). Beginnings of antiseptic surgery in Cleveland. Retrieved from https://artsci.case.edu/dittrick/online-exhibits/explore-the-artifacts/carbolic/
51. King's College London. (2017, March 16). Lord Lister, 'Father of antiseptic surgery'. https://www.kcl.ac.uk/lord-lister-father-of-antiseptic-surgery-2
52. News-Medical.net. (n.d.). History of Asepsis. Retrieved from https://www.news-medical.net/life-sciences/History-of-Asepsis.aspx
53. Science Museum. (n.d.). Joseph Lister's antisepsis system. Retrieved from https://www.sciencemuseum.org.uk/objects-and-stories/medicine/listers-antisepsis-system
54. Toledo, P. (2012). Joseph Lister: father of modern surgery. The American Surgeon, 78(10), E464–E466.
55. Wikipedia. (n.d.). Joseph Lister. Retrieved from https://en.wikipedia.org/wiki/Joseph_Lister
56. Dr. Oracle. (n.d.). What is the diagnosis and treatment for hydrocele (accumulation of fluid in the tunica vaginalis surrounding a testicle)? Retrieved from https://www.droracle.ai/articles/142473/hydrocele
57. Dr. Laurence A. Levine. (n.d.). Aspiration & Sclerotherapy | Hydroceles Treatment Chicago, IL. Retrieved from https://www.drlevinemenshealth.com/mens-health/aspiration-sclerotherapy/
58. CLS Health. (n.d.). Hydrocele Treatment: Hydrocelectomy & Non-Surgical Care. Retrieved from https://cls.health/conditions/hydrocelectomy
59. Li, H., Wang, C., Li, H., & Zhang, X. (2023). A self-treatment case report: curing hydrocele by intracapsular injection of polidocanol. Annals of Medicine and Surgery, 85(3), 1165–1168. https://doi.org/10.1097/MS9.0000000000000287
60. Neonest. (n.d.). Advances In Hydrocele Management: Emerging Therapies And Research. Retrieved from https://neonest.in/advances-in-hydrocele-management-emerging-therapies-and-research/
61. UroPartners. (n.d.). Beyond Surgery: Exploring Aspiration & Sclerotherapy for Hydroceles. Retrieved from https://uropartners.com/news/168

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Works cited

1. en.wiktionary.org, accessed August 6, 2025, https://en.wiktionary.org/wiki/hydrocele#:~:text=Etymology,k%E1%B8%97l%C4%93%2C%20%E2%80%9Ctumour%E2%80%9D).
2. hydrocele - Wiktionary, the free dictionary, accessed August 6, 2025, https://en.wiktionary.org/wiki/hydrocele
3. (PDF) BRIEF SUMMARY: HYDROCELE AND CURRENT THERAPY OPTIONS, accessed August 6, 2025, https://www.researchgate.net/publication/374337202_BRIEF_SUMMARY_HYDROCELE_AND_CURRENT_THERAPY_OPTIONS
4. HYDROCELE Definition & Meaning - Merriam-Webster, accessed August 6, 2025, https://www.merriam-webster.com/dictionary/hydrocele
5. hydrocele, n. meanings, etymology and more - Oxford English Dictionary, accessed August 6, 2025, https://www.oed.com/dictionary/hydrocele_n
6. hydrocoele - Wiktionary, the free dictionary, accessed August 6, 2025, https://en.wiktionary.org/wiki/hydrocoele
7. Hydrocele - StatPearls - NCBI Bookshelf, accessed August 6, 2025, https://www.ncbi.nlm.nih.gov/books/NBK559125/
8. Hydrocele - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/Hydrocele
9. Hydrocele - TeachMePaediatrics, accessed August 6, 2025, https://teachmepaediatrics.com/surgery/urology/hydrocele/
10. Hydrocele - PubMed, accessed August 6, 2025, https://pubmed.ncbi.nlm.nih.gov/32644551/
11. Hydrocele notes - Pulsenotes, accessed August 6, 2025, https://app.pulsenotes.com/surgery/urology/notes/hydrocele
12. The history of varicocele: from antiquity to the modern ERA - PMC - PubMed Central, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5996787/
13. The history of varicocele: from antiquity to the modern ERA, accessed August 6, 2025, https://www.intbrazjurol.com.br/pdf/vol44n03/Marte_563_576.pdf
14. The history of varicocele: from antiquity to the ... - SciELO Brasil, accessed August 6, 2025, https://www.scielo.br/j/ibju/a/q7W7RLmbQWbVw5JLVVsZSLG/?format=html&lang=en
15. Pediatric Hydrocele: A Comprehensive Review - Clinics in Surgery, accessed August 6, 2025, https://www.clinicsinsurgery.com/open-access/pediatric-hydrocele-a-comprehensive-review-2888.pdf
16. Diagnosis of hernia, tumours, elephantiasis, etc. [Chapter XII], accessed August 6, 2025, https://www.wisdomlib.org/hinduism/book/sushruta-samhita-volume-2-nidanasthana/d/doc142870.html
17. Urology in ancient India - PMC - PubMed Central, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC2721488/
18. A Review on concept of Mutravruddhi | Asian Journal of Pharmaceutical Research and Development, accessed August 6, 2025, https://ajprd.com/index.php/journal/article/view/1261
19. surgical procedures in sushruta samhita and its relevance in modern surgery - AYUSHDHARA, accessed August 6, 2025, https://ayushdhara.in/index.php/ayushdhara/article/download/7/7/27
20. Hippocrates - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/Hippocrates
21. Medieval Europe | The British Association of Urological Surgeons Limited, accessed August 6, 2025, https://www.baus.org.uk/museum/81/medieval_europe
22. Ambroise Paré and the Birth of the Gentle Art of Surgery - PMC, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC2605308/
23. Inguinal hernia and hydrocele - Johns Hopkins University, accessed August 6, 2025, https://pure.johnshopkins.edu/en/publications/inguinal-hernia-and-hydrocele
24. Percivall Pott - Eponym - LITFL, accessed August 6, 2025, https://litfl.com/percivall-pott/
25. Percivall Pott - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/Percivall_Pott
26. An account of the method of obtaining a perfect or radical cure of the ..., accessed August 6, 2025, https://wellcomecollection.org/works/d29dy6xn/items?canvas=26
27. History of general anesthesia - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/History_of_general_anesthesia
28. Medical Milestones: Discovery of Anesthesia & Timeline, accessed August 6, 2025, https://www.umhs-sk.org/blog/medical-milestones-discovery-anesthesia-timeline
29. Hydrocele Surgery (Hydrocelectomy) | Saint Luke's Health System, accessed August 6, 2025, https://www.saintlukeskc.org/health-library/hydrocele-surgery-hydrocelectomy
30. Hydrocelectomy: Purpose, Procedure, Risks & Recovery - Cleveland Clinic, accessed August 6, 2025, https://my.clevelandclinic.org/health/procedures/16232-hydrocelectomy
31. Lord Lister, 'Father of antiseptic surgery' | Feature from King's College London, accessed August 6, 2025, https://www.kcl.ac.uk/lord-lister-father-of-antiseptic-surgery-2
32. Joseph Lister: father of modern surgery - PMC, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC3468637/
33. Joseph Lister's antisepsis system | Science Museum, accessed August 6, 2025, https://www.sciencemuseum.org.uk/objects-and-stories/medicine/listers-antisepsis-system
34. Beginnings of antiseptic surgery in Cleveland - Dittrick Medical History Center, accessed August 6, 2025, https://artsci.case.edu/dittrick/online-exhibits/explore-the-artifacts/carbolic/
35. Hydrocele testis - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/Hydrocele_testis
36. History Today in Medicine - Dr. Mathieu Jaboulay - CME INDIA, accessed August 6, 2025, https://cmeindia.in/history-today-in-medicine-dr-mathieu-jaboulay/
37. Hydrocele | Scrotal Lump - Geeky Medics, accessed August 6, 2025, https://geekymedics.com/hydrocele/
38. Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India | International Surgery Journal, accessed August 6, 2025, https://www.ijsurgery.com/index.php/isj/article/view/1103
39. The Western snip, stitch, and tug hydrocelectomy: How I do it - PMC, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5028222/
40. Hydrocele in Children - Stanford Medicine Children's Health, accessed August 6, 2025, https://www.stanfordchildrens.org/en/topic/default?id=hydrocele-in-children-90-P03090
41. Hydrocele: Causes, Diagnosis and Treatment - Nationwide Children's Hospital, accessed August 6, 2025, https://www.nationwidechildrens.org/conditions/hydrocele
42. Hydrocele Repair | Johns Hopkins Medicine, accessed August 6, 2025, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hydrocele-repair
43. Ultrasonography of the scrotum in adults, accessed August 6, 2025, https://www.e-ultrasonography.org/upload/usg-15075.pdf
44. Scrotal ultrasound - Wikipedia, accessed August 6, 2025, https://en.wikipedia.org/wiki/Scrotal_ultrasound
45. Hydrocele Information & Treatment - Columbia Doctors, accessed August 6, 2025, https://www.columbiadoctors.org/health-library/condition/hydrocele/
46. Hydrocele | Radiology Reference Article | Radiopaedia.org, accessed August 6, 2025, https://radiopaedia.org/articles/hydrocele-2
47. Hydrocele - Diagnosis and treatment - Mayo Clinic, accessed August 6, 2025, https://www.mayoclinic.org/diseases-conditions/hydrocele/diagnosis-treatment/drc-20363971
48. What is the diagnosis and treatment for hydrocele (accumulation of fluid in the tunica vaginalis surrounding a testicle)? - Dr.Oracle, accessed August 6, 2025, https://www.droracle.ai/articles/142473/hydrocele
49. www.mayoclinic.org, accessed August 6, 2025, https://www.mayoclinic.org/diseases-conditions/hydrocele/symptoms-causes/syc-20363969#:~:text=Overview,without%20treatment%20by%20age%201.
50. Hydrocele - Children's Hospital of Orange County - CHOC, accessed August 6, 2025, https://choc.org/conditions/urology/hydrocele/
51. Hydrocele - Perth Children's Hospital, accessed August 6, 2025, https://pch.health.wa.gov.au/For-health-professionals/Referrals-to-PCH/Prereferral-guidelines/Hydrocele
52. Hydrocele repair (Chapter 22) - Operative Surgery Vivas for the MRCS, accessed August 6, 2025, https://www.cambridge.org/core/books/operative-surgery-vivas-for-the-mrcs/hydrocele-repair/7A0460254844B47D3182C745063AFB24
53. Advances In Hydrocele Management: Emerging Therapies And Research, accessed August 6, 2025, https://neonest.in/advances-in-hydrocele-management-emerging-therapies-and-research/
54. Aspiration & Sclerotherapy | Hydroceles Treatment Chicago, IL - Laurence A. Levine, MD, accessed August 6, 2025, https://www.drlevinemenshealth.com/mens-health/aspiration-sclerotherapy/
55. A self-treatment case report: curing hydrocele by intracapsular injection of polidocanol, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10006820/
56. Beyond Surgery: Exploring Aspiration & Sclerotherapy for Hydroceles - UroPartners, accessed August 6, 2025, https://uropartners.com/news/168
57. Classifying Hydroceles of the Pelvis and Groin: An Overview of Etiology, Secondary Complications, Evaluation, and Management, accessed August 6, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5436019/
58. A Short History of Anaesthesia Before 1846 - esaic, accessed August 6, 2025, https://esaic.org/a-short-history-of-anaesthesia-before-1846/