What Is a Hydrocele?
A hydrocele is a sac filled with fluid that forms around a
testicle. Hydroceles are most common in babies. According to the Official
Foundation of the American Urological Association, nearly 10 percent of
males are born with a hydrocele. However, they can affect males of any age.
Hydroceles generally don’t pose any threat to the testicles. They’re
usually painless and disappear without treatment. However, if you have scrotal
swelling, see your doctor to rule out other causes such as testicular cancer.
What Causes a Hydrocele?
Towards the end of pregnancy, a male child’s testicles descend
from his abdomen into the scrotum. The scrotum is the sac of skin that holds
the testicles once they descend.
During development, each testicle has a naturally occurring sac
around it that contains fluid. Normally, this sac closes itself and the body
absorbs the fluid inside during the baby’s first year. However, this doesn’t happen
for babies with a hydrocele. Babies born prematurely are at a higher risk for
hydrocele, according to the Mayo
Hydroceles can also form later in life, mostly in men
over 40. This usually occurs when the channel through which the testicles
descend hasn’t closed all the way or reopens. This can cause fluid to move from
the abdomen into the scrotum. Hydroceles can also be caused by inflammation or
injury in the scrotum. The inflammation may be caused by an infection
Types of Hydroceles
The two types of hydroceles are noncommunicating and
A noncommunicating hydrocele occurs when the sac closes, but your
body doesn’t absorb the fluid. The remaining fluid is typically absorbed into
the body within a year.
A communicating hydrocele occurs when the sac surrounding your
testicle doesn’t close all the way. This allows fluid to flow in and out.
What Are the Symptoms of a Hydrocele?
Hydroceles usually don’t cause any pain. Usually, the only
symptom is a swollen scrotum.
In adult men, there may be a feeling of heaviness in the scrotum.
In some cases, the swelling might be worse in the morning than in the evening.
Seek medical treatment if you or your child has sudden or severe
pain in their scrotum. This could be the sign of another condition called
testicular torsion. Testicular torsion occurs when the testicles become
twisted, typically due to an injury or accident. Testicular torsion isn’t
common, but it’s a medical emergency because it can lead to blocked blood
supply to the testicle. If you think you or child has testicular torsion, go a
hospital emergency room right away or call 911. It needs to be evaluated and treated
Diagnosis of Hydroceles
To diagnose a hydrocele, your doctor will perform a physical
exam. If you have a hydrocele, your scrotum will be swollen, but you won’t have
any pain. Your doctor won’t be able to feel your testicle through the
Your doctor may check for tenderness in the scrotum and shine a
light through the scrotum. This is called transillumination. It allows your doctor to determine
if there’s fluid in the scrotum. If fluid is present, the scrotum will allow
light transmission and the scrotum will appear to light up. However, if scrotal
swelling is due to a solid mass (cancer), then the light will not shine through
Your doctor may also apply pressure to the abdomen to check for
another condition called inguinal hernia. This can occur when part of the small
intestine protrudes through the groin due to a weak point in the abdominal
wall. While it’s usually not life-threatening, a doctor may recommend surgery
to repair it.
They may take a blood or urine sample to test for infections. Less
commonly, your doctor may administer an ultrasound to check for hernias, tumors,
or any other cause of scrotal swelling.
How to Treat a Hydrocele
If your new infant has a hydrocele, it will probably go away on
its own in about a year. If your child’s hydrocele doesn’t go away on its own or
becomes very large, he might need surgery.
In adults, hydroceles typically go away within six months,
according to the Mayo
Clinic. A hydrocele usually only needs surgery if it’s a communicating hydrocele
(because it can lead to hernias) or it causes discomfort.
Surgery to remove a hydrocele is performed under anesthesia. In
most cases, you’ll be able to go home within a few hours of the surgery.
A small cut is made in the abdomen or scrotum (depending on the
location of the hydrocele) and the hydrocele is surgically removed. Your surgeon
will most likely apply a large dressing to the site of your incision. You may
also need a drainage tube for a few days.
Risks associated with anesthesia include:
- allergic reactions
- breathing difficulties
- heart rhythm disturbances
Risks associated with this procedure include:
- blood clots or excessive bleeding
- scrotal injury, including nerve damage
Ice packs, a support strap for your scrotum, and plenty of rest
will ease discomfort after the surgery. Your healthcare provider will likely
recommend a checkup exam because a hydrocele can sometimes reoccur.
Another option for hydrocele treatment is to drain it with a long
needle. The needle is inserted into the sac to draw out the fluid. In some
cases, a drug may be injected to prevent the sac from filling again. Needle
aspiration is commonly performed on men who are at high risk for complications
The most common side effects of needle aspiration are temporary
pain in your scrotum and risk of infection.
What to Expect After Surgery
Whether your hydrocele goes away on its own or requires surgery,
the outlook is excellent.
If you have surgery, the pain will probably go away in about a
week. Your doctor may prescribe pain medication if you find it necessary. You
probably won’t return to normal activities for a few weeks. This includes
avoiding anything involving straddling, like riding a bike, for at least three
weeks. Other strenuous activities should also be avoided during that time.
Stitches at the incision site usually dissolve on their own, but
your doctor may want to check them after a few weeks. Keeping the area clean
using showers or sponge baths will help prevent infection.