Dawaa Reference

chronic

Hydrocele (Evaluation & Management)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

EAU Guidelines on Paediatric Urology 2023 · MSF Essential Drugs 2024 - paracetamol (oral)

Verified against1 document
  • MSF Essential Drugs 2024 - paracetamol (oral)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Most patients present with painless swelling of the scrotum [scrotal swelling]
  • A congenital hydrocele often comes and goes, shrinking when lying flat as fluid drains into the abdomen, but pressing on it does not reduce it
  • Because it is painless, a primary hydrocele can grow very large before the patient seeks care
  • Living in a hot climate is a recognized predisposing factor

Signs — what you find (4)

  • The swelling makes the testis impalpable and transilluminates with a positive fluctuation test
  • Being unable to feel above the swelling and palpate the cord suggests hydrocele or hernia rather than another cause [hernia]
  • A hydrocele envelops both testis and epididymis, making neither separately palpable
  • A secondary hydrocele is usually smaller than a primary one, except when caused by filariasis

Tests (7)

  • The diagnosis is usually made clinically; labs and imaging are reserved for excluding other conditions
  • A raised white cell count and a negative transillumination point toward an incarcerated hernia rather than a hydrocele
  • Alpha-fetoprotein and hCG levels are checked when a testicular tumor such as malignant teratoma is suspected
  • Urinalysis and culture can help when epididymitis or orchitis is producing a reactive hydrocele
  • On ultrasound, a hydrocele looks like an anechoic (echolucent) area surrounding the testis
  • Doppler flow is reduced or absent when a hydrocele results from testicular torsion, but increased when it follows epididymitis
  • Plain abdominal x-ray may show bowel gas overlying the groin in an incarcerated hernia

If not this — what else fits (4)

  • An inguinal hernia has an expansile cough impulse and can be reduced, but lacks transillumination and fluctuation
  • A testicular tumor may be suspected when alpha-fetoprotein or hCG markers for a malignant germ cell tumor are raised
  • A spermatocele, testicular tumor, and testicular atrophy can each be told apart from hydrocele on ultrasound
  • A varicocele shows Valsalva-augmented regurgitant flow on duplex ultrasound, unlike a hydrocele

SourceStatPearls "Hydrocele" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g 3 or 4 times daily (max. 4 g daily)

Paediatric dose

10-15 mg/kg/dose [child max 500 mg]

(Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily); Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily))

Dose by weight
3kg30-45 mg/dose
4kg40-60 mg/dose
5kg50-75 mg/dose
6kg60-90 mg/dose
7kg70-105 mg/dose
8kg80-120 mg/dose
9kg90-135 mg/dose
10kg100-150 mg/dose
11kg110-165 mg/dose
12kg120-180 mg/dose
13kg130-195 mg/dose
14kg140-210 mg/dose
15kg150-225 mg/dose
16kg160-240 mg/dose
17kg170-255 mg/dose
18kg180-270 mg/dose
19kg190-285 mg/dose
20kg200-300 mg/dose
21kg210-315 mg/dose
22kg220-330 mg/dose
23kg230-345 mg/dose
24kg240-360 mg/dose
25kg250-375 mg/dose
26kg260-390 mg/dose
27kg270-405 mg/dose
28kg280-420 mg/dose
29kg290-435 mg/dose
30kg300-450 mg/dose
31kg310-465 mg/dose
32kg320-480 mg/dose
33kg330-495 mg/dose
34kg340-500 mg/dose (upper capped)
35kg350-500 mg/dose (upper capped)
36kg360-500 mg/dose (upper capped)
37kg370-500 mg/dose (upper capped)
38kg380-500 mg/dose (upper capped)
39kg390-500 mg/dose (upper capped)
40kg400-500 mg/dose (upper capped)
41kg410-500 mg/dose (upper capped)
42kg420-500 mg/dose (upper capped)
43kg430-500 mg/dose (upper capped)
44kg440-500 mg/dose (upper capped)
45kg450-500 mg/dose (upper capped)
46kg460-500 mg/dose (upper capped)
47kg470-500 mg/dose (upper capped)
48kg480-500 mg/dose (upper capped)
49kg490-500 mg/dose (upper capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Simple analgesic for scrotal heaviness or discomfort while a hydrocele is evaluated; it does not treat the hydrocele itself, which is managed conservatively if asymptomatic and non-communicating or referred for surgery if large, painful, or communicating.

Cautions
  • Asymptomatic non-communicating hydroceles in adults require conservative management and reassurance.
  • Perform transillumination exam and scrotal ultrasound to rule out underlying testicular tumor or epididymitis.
  • Refer for surgical hydrocelectomy if large, painful, or communicating.
  • 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.