What is 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 (testicles). 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 (AMAB), but they’re more common in infants. They can also occur spontaneously in adulthood.

Symptoms of Hydrocele

Hydroceles usually don’t cause any pain. Usually, the most common symptom is a swollen scrotum. However, depending on the severity of the swelling, pain or discomfort may also occur.

In adults, there may be a feeling of heaviness in the scrotum. In some cases, the swelling might be worse in the morning than in the evening. It is not usually very painful. For noncommunicating hydroceles, the size usually stays the same or grows very slowly.

Also, with a communicating hydrocele, there’s the potential for other conditions to also develop. For example, with a communicating hydrocele, the sac doesn’t fully close. In most cases, this means that fluid can travel in and out of the sac. But depending on the size of the remaining opening, it’s possible for a Hernia to also develop.

These are known as inguinal hernias and may require surgery in some cases. If this occurs, the scrotum will appear larger, swollen, and may even change size throughout the day. Inguinal hernias are very painful. So, if your baby has this condition, they won’t stop crying.

Causes of 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.

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.

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 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.

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.

Reference:

https://www.healthline.com/health/hydrocele

https://my.clevelandclinic.org/health/diseases/16294-hydrocele