Hydrocele of the Canal of Nuck: A report of five cases

INTRODUCTION AND IMPORTANCE: Canal of Nuck hydrocele is a rare condition in females. Due to mild symptoms, it may be neglected, leading to complications, including infection and bleeding. The rarity of this condition, coupled with its potential for adverse outcomes, necessitates a high index of suspicion among treating surgeons to diagnose and promptly manage the case. We present five cases of the canal of Nuck hydrocele. CASE PRESENTATION: We prospectively studied five cases of the canal of Nuck hydrocele admitted to our surgical department over two years. Three patients presented with painless, non-tender inguinal swelling, while two had tenderness. Three patients had a right-sided canal of Nuck hydrocele, one had a left-sided, and one had bilateral hydroceles. One patient had an associated indirect inguinal hernia. All patients were treated by carefully dissecting the hydrocele from the round ligament, followed by ligation of the canal of Nuck near the deep inguinal ring. The associated hernia was treated using herniotomy. All patients had an uneventful postoperative course with no recorded postoperative wound infection or recurrence. CLINICAL DISCUSSION: The hydrocele of the Canal of Nuck develops from the failure of complete obliteration of the processus vaginalis in female patients. Most cases are asymptomatic and are usually found incidentally as painless swelling in the inguinolabial region. Surgery is the treatment of choice, as there is an increased incidence of associated complications such as infection and bleeding, and it also helps to confirm the diagnosis. The surgical procedure involves resection of the hydrocele, ligation of the neck of the processus vaginalis, and repair of any associated hernia, if present. CONCLUSION: The canal of Nuck hydrocele is often overlooked in female pediatric patients with inguinolabial masses. Surgeons must maintain a high index of suspicion and perform prompt ultrasound examinations for an accurate diagnosis. Early surgical intervention is of utmost importance for preventing morbidity.