A hydrocele is a fluid-filled sac surrounding a testicle that results in swelling of the scrotum, the loose bag of skin underneath the penis. Up to 10 percent of male infants have a hydrocele at birth, but most hydroceles disappear without treatment within the first year of life. Additionally, adult men can develop a hydrocele due to inflammation or injury within the scrotum.
Hydroceles usually aren't painful. Typically not harmful, hydroceles may require no treatment. However, if you have scrotal swelling, see your doctor to rule out other causes, such as testicular cancer or other conditions.
Usually the only indication of a hydrocele is a painless swelling of one or both testicles. Adult men with a hydrocele may experience discomfort from the heaviness of a swollen scrotum.
When to see a doctor
For your child
For baby boys, a hydrocele can develop in the womb. Normally, the testicles descend from the developing baby's abdominal cavity into the scrotum. A sac (processus vaginalis) accompanies each testicle, allowing fluid to surround the testicles.
In most cases, each sac closes and the fluid is absorbed. However, if the fluid remains after the sac closes, the condition is known as a noncommunicating hydrocele. Because the sac is closed, fluid can't flow back into the abdomen. Usually the fluid gets absorbed within a year.
In some cases, however, the sac remains open. With this condition, known as communicating hydrocele, the sac can change size or, if the scrotal sac is compressed, fluid can flow back into the abdomen.
In older males, a hydrocele can develop as a result of inflammation or injury within the scrotum. Inflammation may be the result of infection of the small coiled tube at the back of each testicle (epididymitis) or of the testicle.
Hydrocele is the type of scrotal swelling that occurs when fluid collects in the thin sheath that surrounds the testicle. ...
Most hydroceles are present at birth (congenital). Otherwise, the condition generally affects men 40 or older. Risk factors include:
A hydrocele typically isn't dangerous and usually doesn't affect fertility. However, it may be associated with an underlying testicular condition that may cause serious complications:
Preparing for your appointment
Get immediate medical treatment if you or your child develops sudden, severe scrotal pain or swelling, especially within several hours of an injury to the scrotum. This may indicate testicular torsion, an emergency medical condition.
If you or your child has painless scrotal swelling, call your doctor. After an initial appointment, your doctor may refer you to a doctor who specializes in urinary tract and male sexual disorders (urologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
For hydrocele, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
If your child is affected:
If you're affected:
What you can do in the meantime
Tests and diagnosis
Your doctor will do a physical exam. The exam may reveal an enlarged scrotum that isn't tender to the touch. Pressure to the abdomen or scrotum may enlarge or shrink the fluid-filled sac, which may indicate an associated inguinal hernia.
Because the fluid in a hydrocele usually is clear, your doctor may shine a light through the scrotum (transillumination). With a hydrocele, the light will outline the testicle, indicating that clear fluid surrounds it.
If your doctor suspects your hydrocele is caused by inflammation, blood and urine tests may help determine whether you have an infection, such as epididymitis.
The fluid surrounding the testicle may keep the testicle from being felt. In that case, you may need an ultrasound imaging test. This test, which uses high-frequency sound waves to create images of structures inside your body, can rule out a hernia, testicular tumor or other cause of scrotal swelling.
Treatments and drugs
For baby boys, hydroceles typically disappear on their own within a year. If a hydrocele doesn't disappear after a year or if it continues to enlarge, it may need to be surgically removed.
For adult males as well, hydroceles often go away on their own. A hydrocele requires treatment only if it gets large enough to cause discomfort or disfigurement. Then it may need to be removed.
Treatment approaches include:
Sometimes, a hydrocele may recur after treatment.
Last Updated: 2009-11-19
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