Filarial Etiology in Vaginal Hydrocele – A Hospital-Based Observational Study from an Endemic Zone of Bangladesh

Open Access

Abstract

Background: Lymphatic filariasis (LF) is a significant cause of long-term disability in endemic low- and middle-income countries, where filarial hydrocele represents the most common chronic manifestation in men, leading to substantial physical, social, and economic consequences. Methods & Materials: This prospective observational study was conducted in the Department of Surgery at Rangpur Medical College Hospital, northern Bangladesh, over 12 months (January–December 2014) among adult males with clinically diagnosed vaginal hydrocele who were admitted from the surgery outpatient department. Data were analyzed using SPSS 26.0, and p < 0.05 was considered statistically significant. Results: Among 100 adult males with vaginal hydrocele, 83% were classified as definite, highly likely, or suspected filarial cases. In contrast, 17% were non-filarial, indicating that most hydroceles in this setting are attributable to lymphatic filariasis. Filarial hydrocele was more frequent among rural residents, those living with poor sanitation, and men working in the biri industry, with significant differences compared to non-filarial cases. In multivariable analysis, rural residence (AOR 3.85; 95% CI 1.42–10.45), poor sanitation (AOR 2.67; 95% CI 1.01–7.08), and employment in the biri industry (AOR 4.28; 95% CI 1.36–13.46) remained independent predictors of filarial hydrocele. Conclusion: In this northern Bangladeshi endemic setting, most adult vaginal hydroceles were filarial and clustered among rural men with poor sanitation and biri-related occupations, indicating that filarial hydrocele is driven by socio-environmental disadvantage and should be addressed through targeted morbidity management, sanitation improvement, and focused preventive strategies for high-risk groups.