Hydrocele

Written by Carmella Wint | Published on June 20, 2012
Medically Reviewed by Peter Rudd, MD

What is a Hydrocele?

A hydrocele is a sac filled with fluid that forms around a testicle. Hydroceles are most common in babies. However, they can affect males of any age. Fortunately, hydroceles do not pose any threat to the testicles. They are also usually painless.

According to the Official Foundation of the American Urological Association, nearly 10 percent of males are born with a hydrocele (AUAF).

What Causes a Hydrocele?

Towards the end of pregnancy, a male child’s testicles descend from his abdomen into the scrotum. The scrotum is a 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. However, this does not happen for babies with a hydrocele.

Hydroceles can also form later in life. This usually occurs when the channel through which the testicles descend has not 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.

Types of Hydrocele

There are two types of hydrocele: noncommunicating and communicating.

Noncommunicating

A noncommunicating hydrocele occurs when the sac closes, but your body does not absorb the fluid. The remaining fluid is typically absorbed into the body within a year.

Communicating

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 Signs of a Hydrocele?

Hydroceles typically do not cause any pain. The only symptom is usually 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.

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 fluid-filled sac.

To aid diagnosis, your doctor may shine a light through the scrotum. This is called transillumination. It allows your doctor to determine if there is fluid in the scrotum. If fluid is present, the scrotum will allow light transmission, and the scrotum will appear to light up.

Hydrocele Treatment

If your new infant has a hydrocele, it will probably go away on its own in about a year. If your child’s hydrocele does not go away on its own, or becomes very large, he might need surgery.

Surgery may also be necessary if the hydrocele is communicating or appears in an adult.

Surgery

Surgery to remove a hydrocele is performed under anesthesia. However, you may be able to go home within a few hours.

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 this procedure include:

  • blood clots scrotal injury infection

Needle Aspiration

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 during surgery.

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 prognosis is excellent.

If you have surgery, pain will likely go away in about a week. Your doctor may prescribe pain medication, if you find it necessary.

You will probably not 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.

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