A man, aged 19, about two years previously received a kick on the scrotum which had become swollen and had remained swollen but had not increased in size. There was never much pain. The patient had dysuria for one night following the accident; micturition was otherwise normal. He never noticed any swelling in the abdomen. There was no cough.
Examination revealed a smooth firm mass in the middle of the lower part of the abdomen, reaching almost to the umbilicus and resembling a dilated bladder in all except tension, being rather softer than a bladder. The right scrotal sac and the inguinal canal were occupied by a semireducible, semitranslucent swelling with a definite impulse on coughing. No testicle could be felt on this side of the scrotum or canal. The left scrotal sac had a normal testicle.
Rectal examination was negative.
On catheterization an ounce of residual urine was obtained