What is Hydrocele?

Hydrocele is a fluid-filled sac that causes swelling around the scrotum in males. The scrotum is the thin pouch of skin that holds the testicles. The condition is painless and non-threatening but can often cause embarrassment or discomfort. Hydrocele is more common in newborns, but the issue usually resolves around age one. In adult males, hydrocele is usually caused by injury or a health condition. Hydrocele may not require treatment and typically resolves on its own. However, it is important to consult with a healthcare professional if you have swelling of the scrotum.

Symptoms

Typically, the most common and sometimes only symptom of hydrocele is painless swelling of the scrotum. If the hydrocele gets bigger, a person may experience a sensation of heaviness and discomfort. Sometimes pain can be associated with increased swelling. It is common for the swelling to be smaller in the morning and bigger later in the day. There are 3 different types of hydroceles. They include:

• Non-communicating hydroceles. This occurs when the scrotum closes, but the body does not absorb the fluid. Usually, the fluid is absorbed back into the body within a year.
• Communicating hydroceles. This occurs when the scrotum does not close all the way and fluid flows in and out of the sac. This type of hydrocele has contact (communicates) with the fluids of the abdominal cavity.

If the hydrocele does not resolve, it is possible for other health conditions to develop. If the opening in the sac is big enough, it is possible for an inguinal hernia to occur. Inguinal hernias are extremely painful and may require surgery. If you notice any symptoms of a hydrocele, it is important to consult with your healthcare professional.

Causes

Hydroceles typically occur in infants, although they can also occur in adolescent and adult males. Typically, the condition is painless and resolves on its own. Hydroceles can occur without any underlying condition, but sometimes occur due to injury or inflammation.

Risk Factors

Newborns are more likely to experience hydrocele than adolescent or adult males. If a newborn is premature, this increases the risk of developing hydrocele. In adult males, risk factors include injury or inflammation, or infections, such as from an STI (sexually transmitted infection). Complications

Hydroceles are usually harmless, however, it is possible that the hydrocele is connected to other health conditions. These health conditions can cause difficulties with male fertility or may even be life-threatening. Possible complications include:

• Infection
• Tumor
• Inguinal hernia

It is important to consult with a healthcare professional to rule out these complications or underlying causes.

Diagnosis

When diagnosing for hydrocele, your doctor will first perform a physical examination. During that exam, your doctor will check for an enlarged scrotum and pain in the area. Your doctor will press on the stomach and scrotum to check for an inguinal hernia. Additionally, your doctor may use a tool that shines a light through the scrotum. If the light appears, it means the sac is filled with fluid. If the light does not pass through, it may indicate a mass inside the sac.

Your doctor may also recommend urine and blood tests to rule out an infection. Sometimes an imaging test, such as an ultrasound, may be recommended to assess for a hernia or tumor.

Treatment

Most hydroceles resolve on their own. In infants, it usually resolves in about a year. In adults who have experienced an injury or have inflammation, or have had an infection that has been treated, the hydrocele may resolve on its own. If the hydrocele does not resolve or it becomes larger, surgery may be required to prevent any further complications.

Another type of treatment is known as aspiration. This occurs when a long needle and syringe are used to drain the fluid filled sac. Additionally, your doctor may also recommend sclerotherapy, which injects chemicals into the sac to prohibit it from refilling with fluid. This treatment is used for older adults who are at a higher risk for experiencing complications during surgery.

Prevention

There are no known measures that can prevent hydrocele from developing in infants. However, in adult males, wearing athletic cups to protect from injury may prevent hydrocele from developing. Although hydrocele is typically a harmless condition, it is important to consult with your healthcare provider if you notice swelling of the scrotum. This helps to rule out other, possibly more harmful conditions.