A hydrocele is a collection of fluid around the testicle.
A hydrocele may be present at birth or may develop later in life. Most often, a parent notices a swelling in a child's scrotum caused by the hydrocele. The fluid that fills the hydrocele is normally present in the abdomen. It seeps through a balloon-like structure around the testicle called the tunica vaginalis. The neck of this balloon runs along a structure in both of the testes called the spermatic cord and opens into the abdomen. Normally, this neck is sealed off before birth. If it fails to close, fluid continues to seep through and cause scrotal swelling.
A painless swelling in the scrotum is a sign of a hydrocele. It may occur on one or both sides.
Hydroceles are more common among premature babies. They develop when the canal between the peritoneal cavity and scrotum fails to close. An inflammation or injury to a testicle may cause a hydrocele.
Boys and men should wear an athletic cup that protects the scrotum when playing sports such as baseball and football. Sports safety guidelines can help prevent injury to the testicles. Since hydroceles are more common among premature infants, prenatal care is important to prevent the premature birth of a baby.
During a physical exam, a healthcare professional finds a mass within the scrotum. The fluid in the hydrocele is clear, so a light can be shined through the scrotum. The outline of the testicle will be visible. An ultrasound may be done to confirm the diagnosis.
If the hydrocele has a big enough opening to let fluid flow in and out, a hernia can occur. When this happens, a piece of the bowel may come down into the scrotum. If the piece of bowel gets stuck outside the abdomen, its blood supply may be cut off and it may die.
This condition is not contagious, so there are no risks to others.
A hydrocele normally repairs itself within a few months after birth. Surgery is recommended if the hydrocele is still present after a baby is 12 to 18 months old. Hydrocele repair is also done for hydroceles that continue to get larger.
Surgery can be complicated by bleeding, infection, or reactions to anesthesia. In addition, the child may develop a blood clot or hematoma, which may gradually drain away on its own. Infertility may result if the vas deferens or epididymis is injured during the surgery.
Rarely, a child may develop another hydrocele that requires more surgery. Most people recover fully after surgery.
If surgery is done, a follow-up visit will be scheduled with the healthcare professional. If surgery is not needed, the size of the hydrocele should be monitored. If the hydrocele contiunes to get larger, surgery may be necessary.
The Merck Manual of Medical Information, Home edition, 1997
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000
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