General Examination
• Patient conscious, cooperative and oriented to time, place and person.
• Examined in a well-lit room after obtaining verbal consent.
• Examination performed in standing and lying positions.
• Pulse: ___/min.
• Blood Pressure: ___ mmHg.
• Respiratory Rate: ___/min.
• Temperature: ___°C.
• BMI: ___.
• Pallor: Present / Absent.
• Icterus: Present / Absent.
• Cyanosis: Present / Absent.
• Clubbing: Present / Absent.
• Lymphadenopathy: Present / Absent.
• Pedal Edema: Present / Absent.
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Local Examination
Inspection
• Site: Right / Left hemiscrotum.
• Size: ___ ×___ cm.
• Shape: Oval / Pear-shaped / Globular.
• Number of swellings: Solitary.
•Enlargement of affected hemiscrotum: Present / Absent.
•Overlying skin: Normal / Abnormal.
•Scar: Present / Absent.
•Sinus: Present / Absent.
•Ulcer: Present / Absent.
•Dilated veins: Present / Absent.
•Median raphe: Central / Deviated to opposite side.
•Position of external genitalia: Central / Deviated to opposite side.
•Visible cough impulse: Present / Absent.
•Redness: Present / Absent.
•Skin changes: Present / Absent.
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Palpation
• Site of swelling: ______.
• Size:___ x ___ cm.
• Margins: Well-defined / Ill-defined.
• Consistency: Cystic.
• Tenderness: Present / Absent.
• Local rise of temperature: Present / Absent.
• Compressibility: Present / Absent.
• Reducibility: Present / Absent.
• Reduction on lying down: Present / Absent.
• Cough impulse: Present / Absent.
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Special Tests
• Fluctuation Test: Positive / Negative.
• Transillumination Test: Positive / Negative.
• Get Above Swelling Test: Positive / Negative.
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Examination of Testis & Epididymis
• Testis palpable separately: Yes / No.
• Position of testis: Normal / Abnormal.
• Consistency of testis: Normal / Abnormal.
• Epididymis palpable: Yes / No.
• Spermatic cord: Normal / Abnormal.
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Opposite Hemiscrotum Examination
• Opposite testis normal: Yes / No.
• Opposite hemiscrotum normal: Yes / No.
• Hydrocele: Present / Absent.
• Varicocele: Present / Absent.
• Epididymal cyst: Present / Absent.
• Testicular tumour: Present / Absent.
• Inguinal hernia: Present / Absent.
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Inguinal Region Examination
• Visible swelling: Present / Absent.
• Palpable swelling: Present / Absent.
• Inguinal hernia: Present / Absent.
• Regional lymph nodes: Palpable / Non-palpable.
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Abdominal Examination
• Organomegaly: Present / Absent.
• Ascites: Present / Absent.
• Intra-abdominal mass: Present / Absent.
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Systemic Examination
Cardiovascular System (CVS)
S1 and S2 normal.
Murmur: Present / Absent.
Added sounds: Present / Absent.
Respiratory System (RS)
Bilateral equal air entry present.
Added sounds: Present / Absent.
Abdomen
Soft / Non-soft.
Tenderness: Present / Absent.
Organomegaly: Present / Absent.
📋 Hydrocele Examination Summary
The patient was conscious and oriented to time, place and person. He was examined in a well-lit room, adequately exposed, in standing and lying positions, after taking verbal consent.
General physical examination revealed pulse _/min, blood pressure _ mmHg, respiratory rate _/min, temperature ___°C and BMI _. Pallor/Icterus/Cyanosis/Clubbing/Lymphadenopathy/Pedal edema were present or absent accordingly.
On local examination of the external genitalia, a solitary globular swelling of size approximately _ × _ cm is present in the right/left side of the scrotum, causing enlargement of the affected hemiscrotum. The overlying skin is normal with no scars, sinuses, ulcers or dilated veins. The median raphe was central/deviated to the opposite side.
No visible cough impulse, redness or skin changes were noted. The external genital appears deviated to opposite side/central.
My inspection findings are confirmed by palpation. A solitary globular lump of size _ × _ cm is present in ___ having smooth surface, well-defined margins, cystic consistency, non-tender, with no local rise in temperature. Fluctuation test is positive. Transillumination test is positive/negative. The swelling is non-reducible and cough impulse is absent. The swelling is not compressible and did not reduce on lying down.
The testis is palpable/not palpable separately from the swelling. The epididymis is palpable/not palpable. One could get above the swelling, suggesting that the swelling is confined to the scrotum. The spermatic cord is normal.
Examination of the opposite testis and hemiscrotum revealed no abnormality. There is no evidence of inguinal hernia, hydrocele, varicocele, epididymal cyst or testicular tumour.
Examination of the inguinal region revealed no visible or palpable swelling. Regional lymph nodes are palpable/not palpable.
Examination of the abdomen revealed no organomegaly, ascites or intra-abdominal mass.
On systemic examination, CVS revealed normal S1 and S2. Respiratory system showed bilateral air entry with no added sounds. Abdomen is soft and non-tender with no organomegaly.
In summary, this is a case of ______ hydrocele involving the right/left tunica vaginalis, presenting as a smooth, cystic, fluctuant, non-tender, transilluminant scrotal swelling with no evidence of associated inguinal hernia or other scrotal pathology.
🎤 One-Line Exam Case Presentation
This is a case of right primary vaginal hydrocele presenting as a smooth, cystic, fluctuant, non-tender, transilluminant swelling of the right hemiscrotum, in which one can get above the swelling and the testis is not palpable separately.
