Hydrocele: Causes, Types, and Treatments

A hydrocele is a collection of fluid in the scrotum.

normal scrotal anatomy Hydrocele

Normal Scrotal Anatomy (left). Scrotal Anatomy with Hydrocele (right)

How common is a hydrocele?

About 10% of newborn male infants have a hydrocele, which often clears up without any particular treatment within the first year of life. Hydroceles occur in only about 1% of adult men, and will often disappear on their own.

Who is at risk of a hydrocele?

Although the condition is much more common in baby boys, it may also occur in adolescent and adult men.

What are the types of hydrocele?

There are two: communicating hydrocele and non-communicating hydrocele.

Communicating hydrocele: This is a type of hydrocele that has contact (communication) with the fluids of the abdominal cavity. A communicating hydrocele is caused by the failure of the processus vaginalis (the thin membrane that extends through the inguinal canal and extends into the scrotum). If this membrane remains open, there is a potential for both a hernia and a hydrocele to develop. The child’s scrotum will appear swollen or large and may change in size throughout the day.
Non-communicating hydrocele: In this type, the inguinal canal did close, but there is still extra fluid around the testicle in the scrotum. This condition might be present at birth or might develop years later for no obvious reason. A non-communicating hydrocele usually remains the same size or has very slow growth.

How is a hydrocele diagnosed? What tests are done?

A healthcare provider can diagnose a hydrocele in a child or adult through a combination of tests and observations, including:

Physical exam - This may include testing to see how the bulge in the groin area changes under pressure or when the patient is asked to cough and/or shining a light through the scrotum, highlighting any collection of fluid in that area.
An imaging test such as an ultrasound.

How is a hydrocele treated? What medicines may help?

There are no medications available to treat a hydrocele.

A hydrocele usually does not need to be surgically repaired. A hydrocele typically goes away on its own within six to 12 months of age. If the hydrocele does not resolve on its own, then it needs to be surgically repaired to prevent further complications.

If my child needs surgery, what happens next?

If your child needs surgery, they will be referred to a pediatric urologist.

Can a hydrocele be prevented?

There is nothing you can do to prevent your baby from getting a hydrocele. For adolescent and adult men, the best protection against a hydrocele is to keep the testicles and scrotum free of injury. For example, if taking part in contact sports, use an athletic cup.

Although hydroceles are usually not a major health issue, you should tell your healthcare provider about any abnormality or swelling in the scrotum. Another disease or condition may be causing or mimicking the abnormality.

The outcome for a hydrocele is generally positive. Cases that need surgery have a high success rate.

Can I live a normal life with a hydrocele?

Yes. A hydrocele shouldn’t interfere with your everyday activities or reduce your quality of life.

Will a hydrocele affect fertility?

No.

When should I see my healthcare provider? When should I take my child to see a healthcare provider?

Contact a healthcare provider right away if your child is in pain.

Call your healthcare provider if you notice any of the following in your infant. These could be signs that part of an intestine has entered the scrotum along with abdominal fluid: