An 84-year-old man presented with painless, soft left scrotal swelling of one year duration. There was no testicular mass by palpation or ultrasound. It is important to ascertain that the sac is not secondary to a testicular tumor. The surgical approach is radically different. In this view the scrotum has been incised and the hydrocele sac exteriorized.
The scrotal skin and Dartos' fascia were incised down to hydrocele sac. The sac was easily peeled out of the scrotal sac by gentle circunferential pressure.
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