A hydrocele is a collection of fluid in the scrotum. It is not a major health issue but it can be embarrassing and uncomfortable. Hydroceles are more common in male infants than adults.
About 10% of newborn male infants have a hydrocele, which often clears up without any particular treatment within the first year of life.
Although hydroceles tend to be fairly harmless in most patients, the condition can present differently depending on how it develops in the body. The two most common forms are –
• Noncommunicating hydroceles occur when the sac closes, but your body doesn’t absorb the fluid. The remaining fluid is typically absorbed into the body within a year.
• Communicating hydroceles occur when the sac surrounding your testicle doesn’t close all the way. This allows fluid to flow in and out.
Usually, the only indication of a hydrocele is a painless swelling of one or both testicles.
Adult men with a hydrocele might experience discomfort from the heaviness of a swollen scrotum. Pain generally increases with the size of the inflammation. Sometimes, the swollen area might be smaller in the morning and larger later in the day.
If sudden scrotal pain or swelling occurs, especially after an injury to the scrotum, it is important to get medical help straight away.
These symptoms can stem from restricted blood flow in a twisted testicle (testicular torsion), which requires immediate treatment.
The cause of a hydrocele depends on a person’s age.
• In babies
When a male fetus is growing during pregnancy, the testicles develop near the kidneys in the abdomen. By the end of a full-term pregnancy, they move down to their usual position in the scrotum.
To allow the testicles to descend, a muscle lining opens in the scrotum (the inguinal ring), forming a canal or sac.
Once the testicles have moved into their usual position, the inguinal ring closes. If the ring stays open or reopens, fluid can pass from the belly to the scrotum through this canal, and this causes a hydrocele.
Sometimes, babies are born before the testicles have descended, increasing the chances of a hydrocele developing.
• In adults
In older males, if the inguinal ring has not closed up or it reopens, a communicating hydrocele can form.
Hydroceles in adult males have several other possible causes, including –
A hydrocele is unlikely to be painful, but it can cause an uncomfortable feeling of heaviness in the scrotum.
A hydrocele is not usually dangerous and will not affect fertility. In rare instances, it might link to an underlying testicular condition, such as an infection, tumor, or inguinal hernia.
Risk factors –
Most hydroceles are present at birth. At least 5 percent of newborn boys have a hydrocele. Babies who are born prematurely have a higher risk of having a hydrocele.
Risk factors for developing a hydrocele later in life include –
• Injury or inflammation to the scrotum
• Infection, including a sexually transmitted infection (STI)
A hydrocele typically isn’t dangerous and usually doesn’t affect fertility. But a hydrocele might be associated with an underlying testicular condition that can cause serious complications, including –
• Infection or tumor. Either might reduce sperm production or function.
• Inguinal hernia. The loop of intestine trapped in the abdominal wall can lead to life-threatening complications.
A healthcare provider can diagnose a hydrocele in a child or adult through a combination of tests and observations, including –
• Physical exam – This may include testing to see how the bulge in the groin area changes under pressure or when the patient is asked to cough and/or shining a light through the scrotum, highlighting any collection of fluid in that area.
• An imaging test such as an ultrasound.
Most babies and infants with a hydrocele will not require any treatment, as the condition will resolve over time.
Parents and caregivers should check the scrotum now and then and contact their doctor if the swelling becomes very large, or if the infant is in pain.
For people with very large and uncomfortable hydroceles, surgery to remove them might be the best option.
Another treatment option is to drain the hydrocele using needle aspirationTrusted Source. In this procedure, a doctor inserts a long needle into the sac to draw out the fluid. They may then inject chemicals into the hydrocele to stop it refilling with fluid (sclerotherapy). This treatment is best for adults at risk of complications during surgery.
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