- Upon examination of a newborn male, a cystic structure is found in the scrotum. It is determined that there is a hydrocele of the spermatic cord. Which of the following is the most likely etiology of this finding?
B. Failure of the processus vaginalis to form
C. Failure of the processus vaginalis to fuse
D. Incomplete fusion of the processus vaginalis
E. Varicosities of the spermatic vein
The correct answer is D. The processus vaginalis is an evagination of the parietal peritoneum of the abdomen that descends through the inguinal canal before the descent of the testis. Normally, the distal end of this evagination remains patent as the tunica vaginalis and the remainder of the processus vaginalis fuses and becomes fibrous. If a part of the processus vaginalis does not fuse (incomplete fusion), the resulting cystic structure is a hydrocele of the spermatic cord.
A communication between the epididymis and the tunica vaginalis (choice A) will result in the passage of sperm into the epididymis. This is a spermatocele.
Failure of the processus vaginalis to form (choice B) would result in an absence of the tunica vaginalis.
Total failure of the processus vaginalis to fuse (choice C) results in a persistent processus vaginalis. This results in congenital inguinal hernias.
Varicosities of the spermatic cord (choice E) or the pampiniform plexus is termed a varicocele.