Hydrocele

Last reviewed by Dr.Mary on August 7th, 2018.

What is Hydrocele?

This is a sac that is fluid filled and surrounds a testicle resulting in swelling scrotum. The scrotum is the bag of loose skin beneath the penis. Approximately 10% of all boy babies have a hydrocele when born, but these hydroceles vanish without any treatment in the 1st year of life. In addition, adult males can likewise acquire a hydrocele because of any injury or inflammation inside the scrotum sac.


Hydroceles normally are not painful. Normally they are also not harmful and usually need no treatment. But, when there is any scrotal swelling, an individual should see their primary care physician in order to exclude any problems, such as cancer or other conditions.

Hydrocele Symptoms

Normally the only sign or indication of a hydrocele is the swelling, usually painless, of one or both testicles. Adult males with a hydrocele can have a sensation or discomfort from the heaviness of the swollen scrotum.

Any adult male should see their primary care physician if there is any scrotal swelling. It is very important to exclude other probable reasons for this swelling, for instance a tumor. Frequently a hydrocele is linked to an inguinal hernia, where a point of the abdomen wall that is weak lets an intestinal loop migrate into the scrotum sac and can need treatment.

For a baby with swelling of the scrotum, make arrangements for a visit with the child’s physician. If the physician diagnoses the cause of the swelling to be a hydrocele, it will normally go away on its own within a year. But, if the baby’s hydrocele does not go away after that time, or if it becomes larger the baby needs to be re-evaluated.

Hydrocele Causes

For male babies, a hydrocele may happen in the womb. Usually, the testicles normally drop away from the growing baby’s cavity of the abdomen to the scrotum. A processor vaginalis or sac supplements each testicle, letting fluid encircle the testicles.

In the majority of cases, each of these sacs close as well as the fluid is absorbed. But, if this fluid stays after these sacs close, this condition is referred to as “non-communicating hydrocele”. Since the sac is already closed off, the fluid cannot run back into the abdomen. Normally this fluid gets soaked up within 12 months.

But in other cases, the sac stays open. This condition, referred to as “communicating hydrocele”, these sacs may change size or, if the scrotal sac is compacted, the fluid may run back into the abdomen.

In males who are older, a hydrocele can occur because of an injury or inflammation within the scrotum. When the scrotum is inflamed it can be created by an infection of the tube that is small coiled and located at the back of the testicle, epididymitis, or of the testicle.

Many hydroceles are congenital and mean they are present at birth. Then, this condition usually affects men over the age of 40 or older. Factors for risk consist of:

  • Infection, including many sexually transmitted diseases
  • Scrotal injury
  • Radiation treatment

A hydrocele normally is not dangerous nor does it usually affect fertility. But, it can be linked with another underlying condition with the testicule that can create serious complications:

  • Tumor or infection – Either one can reduce the production of sperm or functioning
  • Inguinal hernia – An intestinal loop can be trapped in the point of the abdominal wall – strangulated – and this is a life-threatening condition.

Hydrocele Treatment

The physician will first perform a physical examination. This exam can disclose an enlarged scrotum what with no tenderness to the touch. Compression to the scrotum or abdomen can shrink or enlarge the sac which is fluid-filled, which can be an indication of a related inguinal hernia.

Since the fluid in hydrocele normally is clear, the physician can take a light and shine it thru the scrotum. This is referred to as transillumination. In a hydrocele, this light will cause an outline of the testicle which is an indication that clear fluid is encasing it.

If the doctor has a suspicion that the hydrocele is the cause of an inflammation – urine and blood tests can help to determine whether it is caused by an infection, for instance epididymitis.

Any fluid round the testicle can stop the testicle from the ability to be felt. If that is the case, an ultrasound may be needed. This test creates images of structures inside the body, using high-frequency sound waves – can rule out a testicular tumor, a hernia or other causes of swelling of the scrotum.

Hydrocele Surgery or Repair

With infant males, hydroceles normally just disappear by itself within 12 months. But if it does not disappear or if it persists to get larger, it may be necessary to be removed surgically.

For adult men also, hydroceles often go away on their own. A hydrocele needs treatment only if it gets large enough to cause disfigurement or discomfort. Then it is possible that it might have to be removed.

These treatment approaches consists of:

Hydroceloectomy or surgical excision

The exclusion of a hydrocele can be done as as outpatient with the use of spinal or general anesthesia. The surgeon will create an incision in the scrotum or in the lower abdomen in order to eliminate the hydrocele. If the hydrocele is only exposed during surgery to mend an inguinal hernia, the physician can eliminate it even if no discomfort is being created..

The hydrocelectomy can need a drainage tube as well as to wear a dressing that is bulky over the incision site for several days after surgery. The individual may also be advised to wear a support for the scrotum for some period after surgery. Packs of ice need to be applied to the area for the first day after surgery to help with the reduction of swelling. Surgical complications can include infection, any injury to the scrotum or blood clots.

Needle aspiration

This is an option to eliminate the fluid in the scrotum by a needle. This is a treatment that is not widely used since it is common for the fluid to return. There is an injection of a hardening or thickening (sclerosing) drug can be used after the aspiration in order to stop the fluid from reaccumlating. Aspiration as well as injection can be an option for males who have any risk factors that can make other surgery more dangerous. Hazards of this process include scrotal pain as well as infection.

Often, a hydrocele can recur after treatment.

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