HYDROCELE

WHAT IS A HYDROCELE?

• A hydrocele (HI-dra-seel) is a fluid-filled sac in your scrotum that causes

swelling. Your scrotum is the pouch of skin behind your penis that holds your
testes. A hydrocele may affect one side of your scrotum or both sides. Another
name for hydroceles around both of your testicles is a bilateral hydrocele.
• Hydroceles can affect anyone assigned male at birth, but they’re more common
in infants.
• They can also occur spontaneously in adulthood.
 HOW SERIOUS IS A HYDROCELE?

• Hydroceles can be alarming because they cause swelling in a sensitive part of

your body and can happen suddenly. In some instances, hydroceles can be
bothersome depending on their size. A large hydrocele may cause discomfort
while sitting or walking. However, in many people, a hydrocele isn’t serious,
bothersome or painful.
 WHAT ARE THE TYPES OF
HYDROCELES?
• Communicating hydrocele • Noncommunicating hydrocele
 A communicating hydrocele has contact with the fluids  In a noncommunicating hydrocele, the processus
in your abdominal cavity. Your abdominal cavity is the vaginalis closes. But there’s still some extra
space within your abdomen that contains your stomach, abdominal fluid around the testicle in the scrotum.
intestines, liver, kidneys and other organs. Noncommunicating hydroceles may be present at
Communicating hydroceles occur in birth or develop years later for no obvious reason.
fetal development.
 If you or your child has a noncommunicating
 During development, a thin membrane forms between hydrocele, it usually remains the same size or
some tissues in the fetus’s stomach lining (inguinal grows very slowly.
canal) and the scrotum. This membrane is the
processus vaginalis. Normally, the testicles slide
(descend) from the abdomen through the processus
vaginalis into the scrotum. Tissue then forms to seal the
opening (communication). If a seal doesn’t form, fluids
from the abdominal cavity can flow into the scrotum
and cause a hydrocele or hernia.
 If you or your child has a communicating hydrocele,
the scrotum will appear large or swollen, and it may
change in size throughout the day.
 SYMPTOMS AND CAUSES

• The main symptom of a hydrocele is swelling on

one or both sides of your scrotum that may feel
like a water balloon. You might notice other
symptoms in your scrotum, like:
Swelling that changes in size during the day.
Discomfort.
Pain.
A feeling of heaviness.
 DIAGNOSIS AND TESTS

How is a hydrocele diagnosed?

• A healthcare provider can diagnose a hydrocele in a child or adult. They’ll ask questions about your
symptoms and perform a physical examination.
• During the physical exam, the provider may apply pressure to the groin area or ask you to cough to
see how the swelling changes. They may shine a light through your scrotum to highlight any
abdominal fluid in the area. A provider can diagnose most hydroceles from a physical exam alone.
To confirm their diagnosis, the provider may order imaging tests, including:
• Pelvic ultrasound. A pelvic ultrasound uses high-frequency sound waves to create images of the
soft tissues in your pelvis, including your testicles. It’s the most common imaging test providers
order for a hydrocele diagnosis.
• Computed tomography (CT) scan. A CT scan is a type of X-ray that takes cross-section pictures
of your body — like slices — to create 3D images of your testicles. A CT scan is more precise than
a standard X-ray.
 WHAT ARE THE COMPLICATIONS OR SIDE
EFFECTS OF HYDROCELE SURGERY?

A hydrocelectomy is a relatively safe procedure. But all surgeries carry some risk.
Some hydrocele surgery risks include:
• Anesthesia risks.
• Infection.
• Swelling.
• Bruising.
• Scarring.
• The hydrocele comes back (recurrence).
 MANAGEMENT AND TREATMENT

What is the best treatment for a hydrocele?

 A hydrocele usually doesn’t need treatment.
Will a hydrocele go away by itself?
 Most hydroceles go away on their own without treatment. But if a hydrocele doesn’t resolve on its own, a
healthcare provider may recommend a hydrocelectomy. During a hydrocelectomy, a surgeon will remove the
hydrocele. If you have a communicating hydrocele, they’ll close the opening between your processus vaginalis and
scrotum.
What shrinks a hydrocele?
 If a hydrocele doesn’t go away on its own, the only way to correct it is to have surgery. There aren’t any
medications available to shrink a hydrocele.
What happens if a hydrocele is left untreated?
 Though rare, an inguinal hernia can develop if the processus vaginalis opening is large and doesn’t receive
treatment. An inguinal hernia causes part of your intestine or intestinal fat to push through the inguinal canal in
your groin. It can be painful and, in some cases, dangerous.
 PREVENTION

Can a hydrocele be prevented?

• There’s nothing you can do to prevent your baby from getting a hydrocele.
• For older children, adolescents and adults, the best way to prevent a hydrocele
is to protect your testicles and scrotum from injury. It’s a good idea to wear an
athletic cup if you play sports or participate in other vigorous activities.
Will a hydrocele affect fertility?
• Hydroceles usually don’t cause infertility.
What causes a hydrocele?
• Infants that have a hydrocele are usually born with it. Hydroceles are typically part of fetal
development, when abdominal fluid can flow into the scrotum if the processus vaginalis doesn’t close.
And sometimes, even if the processus vaginalis closes, abdominal fluid may remain in the scrotum.
Your child’s body usually absorbs this fluid within the first two years.
Who do hydroceles affect?
• Hydroceles are much more common in babies and infants, but may also occur in adolescents and
adults.
• About 10% of newborn infants have a hydrocele, which often clears up without treatment within the
first year.
• Hydroceles occur in only about 1% of adults. They often disappear on their own without treatment.
What causes a hydrocele in adults?
• In older children, teenagers or adults, a hydrocele can form as a result of an injury to or inflammatory
infection of the scrotum.