Hydrocele of the canal of nuck: a case series and literature review

Hydrocele of the Canal of Nuck is a rare differential for a groin lump in females. It has a heterogeneity of presentations clinically: majority are associated with a groin hernia and most cases are incidentally discovered during pre-operative imaging for groin lumps in females.

The purpose of this study is to discuss the clinical, radiological, histopathological findings, and the surgical treatment of this disease, with reference to prior published literature.

We report our experience on cases of hydroceles of the Canal of Nuck in female adults, treated at our hernia centre with open and laparoscopic approaches from 2013 to 2026. A literature review was performed to compare our experiences with previously reported cases.

We reported 31 patients with hydrocele of Canal of Nuck. Twenty seven patients had pre-operative imaging with Ultrasound, Computed Tomography or Magnetic Resonance Imaging, which demonstrated the Canal of Nuck. The other four patients were incidental diagnoses made intra-operatively during inguinal hernia repair. All patients who had surgery with extra-peritoneal approach had concurrent indirect inguinal hernia which were repaired with a mesh in addition to the excision of the cyst. In two cases, multiple cysts were noted along the round ligament. All patients recovered well after surgery, with one having a seroma which resolved in 1 month. No complications or recurrence up to a minimum follow-up duration of 6 months.

Hydrocele of Canal of Nuck is a rare condition. The differential diagnosis often includes more common causes of inguinal hernia. Most patients have associated indirect inguinal hernia or occult hernia, therefore an extra-peritoneal approach during exploration and excision of the cyst with concurrent mesh repair of the inguinal hernia is advisable to avoid future complications.