FIGURE 61.8 Hydrocele Waxing and waning of size indicates a communicating hydrocele with a patent processus vaginalis, requiring surgical correction Occasionally, a hydrocele of the cord presents as a scrotal swelling just above the testis Differentiation from an incarcerated hernia may be difficult and an ultrasound may be helpful Surgical treatment like that for a hydrocele of the testis is appropriate Hernia Although most inguinal hernias present in children with a mass in the groin, occasionally the hernia may extend and present as scrotal swelling An incarcerated hernia may produce pain in some patients The diagnosis and treatment of inguinal hernias are discussed in Chapter 116 Abdominal Emergencies Varicocele