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A hydrocele occurs when the fluid from the abdomen accumulates in a sac in the scrotum, making it swell. Swelling is the primary symptom of this condition and can cause pain or discomfort.
Hydroceles are more prevalent among infants compared to adults, but they usually resolve on their own. Surgery may, however, be necessary if hydrocele does not naturally disappear.
By Able Health I Medically reviewed by Dr. Alireza Estedlal
Page last reviewed: February 2024 I Next review due: February 2026
A hydrocele refers to the fluid-filled sac that forms in the scrotum, causing swelling. The scrotum is the skin pouch holding testicles (testes) behind the penis, and hydrocele can occur on one or both sides. Hydroceles affecting both testicles are known as bilateral hydroceles.
Although hydroceles may form in every person assigned male at birth (AMAB), they are usually common among infants. In addition, they could happen spontaneously in adults.
Hydroceles are generally harmless; however, the condition may manifest in various forms based on how they occur in the body. Noncommunicating and communicating hydroceles are two common types.
The common hydrocele symptom is swelling on one or both sections of the scrotum, often described as the feeling of a water balloon. Other noticeable symptoms around the scrotum are:
Hydroceles in infants are usually congenital. During fetal development, abdominal fluids may flow into the scrotum when the processusvaginalis fails to close. However, in some cases where the processusvaginalis closes, the fluid could remain in the scrotum. Usually, the body absorbs this fluid during the initial two years of the child’s life.
Towards the end of the pregnancy, the testicles of a child descend into the scrotum from the abdomen. The scrotum is the skin sac holding the testicles after descending.
A naturally forming sac containing fluid during the child’s development surrounds each testicle. The sac usually closes on its own and the fluid inside is absorbed by the body in the first year of the baby. This process does not, however, occur in infants with hydroceles. Premature babies also have increased risks of hydrocele.
In adults, hydroceles can develop later, mostly in males above 40 years. They may result from hernias, although this is rare. More often, a hydrocele is caused by inflammation or problems with the tunica vaginalis sac when it doesn’t reabsorb fluid correctly.
The epithelial cells in the tunica vaginalis are responsible for constant production and reabsorption of fluid. However, any malfunction in these cells causes excessive fluid accumulation.
In addition, hydroceles in adults can occur following an injury or inflammation in the scrotum or beside the channel. Inflammation might result from an infection like epididymitis or other conditions.
While hydroceles are more frequent among infants and minors, they can also develop in adults and adolescents. Nearly 10 percent of newborn babies have hydroceles that usually go away within their first year of life without treatment.
Hydroceles in adults are less common and affect approximately 1 percent of the population. They usually clear up on their own without any treatment.
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Hydroceles in children and adults can be diagnosed through a combination of symptom assessment and physical exam.
Medical providers conduct a physical examination by applying pressure on the groin region or asking you to cough to observe changes in the swelling. They can also use a light to shine through the scrotum to detect the presence of abdominal fluid. Many cases of hydroceles can be diagnosed through a physical exam only.
In order to confirm a diagnosis, the doctor can recommend imaging tests such as:
If a newborn has a hydrocele, there is a high chance that it will disappear on its own within a year. However, if it doesn’t clear up or enlarge, a surgical procedure by a urologist may be necessary.
Hydroceles in adults might clear up only when the cause was inflammation, such as trauma or infection, and have been addressed. For small hydroceles with promising results from physical examination and ultrasound they are often monitored for some time to see whether they disappear on their own.
On the other hand, if the hydroceles are large, they are considered hernias and will require surgical repair by a general surgeon. For noncommunicating cases, which are more common among adults, surgery may be necessary since their sizes don’t change or gradually enlarge with time.
The surgical procedure to take out hydroceles is usually done under anesthesia. Most patients can return home in a few hours after surgery.
The procedure involves creating a tiny cut in the abdomen or scrotum based on the hydrocele location. In most cases, a large dressing is applied on the incision site. A drainage tube may also be required for a few days, depending on the size and location.
Needle aspiration is another treatment option for hydrocele, which involves draining it using a long needle. The procedure is done by inserting the needle into the sac to extract the fluid. Sometimes, the provider can inject a drug to prevent refilling of the sac.
This treatment method is usually recommended for people with increased risks of surgical complications.
The common needle aspiration side effects include temporary discomfort in the scrotum and infection risk.
See a doctor if you notice swelling in the scrotum of your child or observe any of these signs:
Consider asking your doctor these questions if you or your kid has hydrocele:
A hydrocele is a common problem causing swelling in one or both sections of the scrotum, especially in infants. Although discussing scrotal symptoms can be awkward, it is crucial to consult a doctor if you notice any swelling. They can give an official diagnosis and advise on the best treatment options.