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Hydrocele

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Overview

What is Hydrocele

A hydrocele (HI-droe-seel) is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle. Hydrocele is common in newborns and usually disappears without treatment by age 1. Older boys and adult men can develop a hydrocele due to inflammation or injury within the scrotum.

Hydrocele

Symptoms

Usually, the only indication of a hydrocele is a painless swelling of one or both testicles.

Adult men with a hydrocele might experience discomfort from the heaviness of a swollen scrotum. Pain generally increases with the size of the inflammation. Sometimes, the swollen area might be smaller in the morning and larger later in the day.

Causes

A hydrocele can develop before birth. Normally, the testicles descend from the developing baby’s abdominal cavity into the scrotum. A sac accompanies each testicle, allowing fluid to surround the testicles. Usually, each sac closes and the fluid is absorbed.

Sometimes, the fluid remains after the sac closes (noncommunicating hydrocele). The fluid is usually absorbed gradually within the first year of life.

Diagnosis

Our doctor will start with a physical exam. It’s likely to include:

  • Checking for tenderness in an enlarged scrotum.
  • Applying pressure to the abdomen and scrotum to check for inguinal hernia.
  • Shining a light through the scrotum (transillumination). If you or your child has a hydrocele, transillumination will show clear fluid surrounding the testicle.

Treatment

In baby boys, a hydrocele sometimes disappears on its own. But for males of any age, it’s important for a doctor to evaluate a hydrocele because it can be associated with an underlying testicular condition.

A hydrocele that doesn’t disappear on its own might need to be surgically removed, typically as an outpatient procedure. The surgery to remove a hydrocele (hydrocelectomy) can be done under general or regional anesthesia. An incision is made in the scrotum or lower abdomen to remove the hydrocele. If a hydrocele is found during surgery to repair an inguinal hernia, the surgeon might remove the hydrocele even if it’s causing no discomfort.

Frequently Asked Questions

For people with very large and uncomfortable hydroceles, surgery to remove them might be the best option. Another treatment option is to drain the hydrocele using needle aspiration . In this procedure, a doctor inserts a long needle into the sac to draw out the fluid.
Simple hydroceles in children often go away without surgery. In adults, hydroceles usually do not go away on their own. If surgery is needed, it is an easy procedure with very good outcomes. After surgery, a hydrocele can sometimes reoccur.
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.
A non-communicating hydrocele usually remains the same size or has a very slow growth. If a communicating hydrocele does not go away on its own and is not treated, it can lead to an inguinal hernia. In this condition, part of the intestine or intestinal fat pushes through an opening (inguinal canal) in the groin area.
In adults, hydroceles typically go away within six months, according to the Mayo Clinic. A hydrocele usually only needs surgery if it causes discomfort or if it's a communicating hydrocele, which can lead to hernias.
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