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Hydrocele

A hydrocele is a collection of fluid around one or both testicles. It can cause the scrotum or groin to swell. Hydroceles are most common in newborns and infants, but can occur at any age. There are two types of hydroceles, communicating and non-communicating.

Causes

Non-Communicating is developed during the baby’s development in the womb, the testicles come down from the abdomen through a canal and into the scrotum. If this canal does not close right after the testicles have come down, fluid from the abdomen can drain through the open canal and get trapped in the scrotum, causing a hydrocele.

Communicating takes place when the canal that the testicles came down through remains open after birth, fluid from the abdomen can go back and forth between the abdomen and scrotum and cause changes in size of the bulge in the scrotum. Children with communicating hydroceles may also have a hernia (intestines moving through the open canal.)

Symptoms

Hydroceles are most often painless. The main symptom is a swollen testicle that feels like a water balloon.

Diagnosis

A hydrocele is usually diagnosed by an exam of the scrotum and testicles. You or your child’s healthcare provider may notice that the scrotum appears larger on one or both sides. As part of an exam, the healthcare provider may shine a light behind each testicle (transillumination). Hydroceles, which are filled with fluid, will allow the light to shine through them.

A testicle ultrasound is sometimes (but not often) used to confirm the diagnosis of hydrocele

Treatment

Non-communicating hydrocele: This often goes away on its own as the fluid around the testicle is reabsorbed by the body. This usually happens within the first year of life in infants.

If the fluid does not go away after one year of life in infants, a surgery to drain the fluid may be recommended. A small incision is made in the scrotum and the fluid is drained.

Communicating hydroceles: This often requires surgery. During surgery, a small incision is made in the groin. The open channel between the abdomen and scrotum that is allowing fluid to drain into the scrotum is surgically closed. The fluid from the hydrocele will be drained. If a hernia is also found, this will be repaired. Your child's healthcare provider will talk with you about what treatment, if any, is recommended for your child.

Your child may be referred to an urologist (a physician who specializes in disorders and care of the urinary tract and the male genital tract) for evaluation and treatment.

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