Which feature favors a hydrocele over a solid scrotal mass?

Which feature favors a hydrocele over a solid scrotal mass?

• A. Non-transillumination
• B. Painful swelling
• C. Masses fixed to scrotum
• D. Swelling worsens with Valsalva and transilluminates

Answer: (D)

Transillumination is the key clue here. A hydrocele is a fluid-filled sack around the testicle, so when you shine a light through the scrotum, the fluid allows light to pass and the swelling will glow (transillumination). A solid scrotal mass, like a tumor, does not transmit light and remains dark. So the presence of transillumination strongly favors a hydrocele over a solid mass. The part about swelling changing with Valsalva is more typical of a hernia, but the transillumination finding is the decisive feature.

Transillumination is the key clue here. A hydrocele is a fluid-filled sack around the testicle, so when you shine a light through the scrotum, the fluid allows light to pass and the swelling will glow (transillumination). A solid scrotal mass, like a tumor, does not transmit light and remains dark. So the presence of transillumination strongly favors a hydrocele over a solid mass. The part about swelling changing with Valsalva is more typical of a hernia, but the transillumination finding is the decisive feature.