What is a Hydrocele?

A hydrocele is a fluid-filled sac surrounding a testicle that causes swelling in the scrotum. Normally, though visibly noticeable hydroceles, are painless conditions. It is more common in newborns and when monitored by a physician will normally clear up without incident. In extreme cases of hydrocele, surgical intervention or aspiration (draining with a needle) can be an option from doctors at Cleveland Clinic.

Note: Abnormality or pain in the groin may stem from testicular torsion, an emergency condition that requires immediate medical attention at the closest medical facility.

How often does hydrocele occur?

Hydroceles occur in only about 1% of adult men and is more common in baby boys. In adults, a hydrocele can develop as due to an injury or infection of the scrotum.

What Causes Hydroceles?

Hydroceles are common in newborn males. During development the testicles descend from the abdomen to the scrotum down a tract known as the processus vaginalis. When this tract fails to close after their descent, the scrotum can fill with fluid from the abdomen. This situation usually resolves within a few months. In men, hydroceles can result from inflammation in their reproductive system, from injury or from an obstruction in the spermatic cord.

How are Hydroceles Diagnosed?

Hydroceles are diagnosed by a physical examination of the scrotum. The first thing the doctor will do is rule out testicular torsion as a cause. This is a serious condition that requires immediate attention and is usually painful. With hydrocele, the scrotum is enlarged but not tender. Because the fluid causing the swelling is clear, a flashlight shined through the scrotum will show the outline of the testes. This illumination suggests the problem is hydrocele but is not diagnostic.

Ultrasonography is used to confirm a diagnosis and to rule out other possible problems. Ultrasound imaging uses sound waves that bounce off internal organs and structures. These echos are converted to images (sonograms) by a computer.

When the conditions are painful, laboratory tests such as complete blood counts and urinalysis may be used to determine if inflammation and infection are present.

What are the Symptoms of a Hydrocele?

Hydrocele is an accumulation of fluid in the scrotum. Hydroceles tend to appear as a swelling in one or both testicles. The scrotum with hydrocele has been described as feeling like a water-filled balloon. If pain is present, it indicates inflammation of the epididymis.

How are Hydroceles Treated?

There are no medications for the treatment of a hydrocele. Analgesics may be prescribed to relieve pain. Surgical procedures are not frequently employed for hydrocele. One reason is that the conditions tend to recur following surgery.

Surgical interventions are used in infants to close the processus vaginalis when it fails to close naturally. In adults, surgical procedures may be employed when the swelling is painful, embarrassing or when it grows to a size that threatens the function of other anatomy within the scrotum.

Hydroceles are drained under local anesthetic by making an incision in the scrotum or groin close to the scrotum. This is a minor surgical procedure and patients return home soon after it has been completed. Ice packs are applied for the first 24 hours following the procedure. A second procedure in which a needle is used to draw off the fluid (aspiration) is seldom used anymore.

Can I Prevent Hydroceles?

Currently, doctors aren't sure how to prevent hydrocele in infants. However, when hydroceles occur in adult men as a result of trauma to the testicles, it is best to try to prevent the trauma from occurring at all. Wearing a protective athletic cup during sports activities that testicular trauma might occur is a good way to prevent hydroceles. Although these hydroceles are considered benign, any abnormality in the scrotum should be investigated. Any abnormality or pain in the groin may stem from testicular torsion, an emergency condition that requires immediate medical attention at the closest medical facility.