Cholesterol crystals in hydroceles: sonographic detection and possible significance

The aim of this study of seven patients who had elective surgical repairs of a hydrocele was to try to differentiate by microscopy and chemical analysis hyperechoic hydrocele fluid from the more typical anechoic hydrocele fluid. Hyperechoic hydrocele fluid is related to the presence of cholesterol crystals. Cholesterol crystals were noted on microscopic examination in all three patients with hyperechoic hydrocele fluid. No cholesterol crystals were evident in the four patients with typical anechoic hydrocele fluid.