A hydrocele occurs in males when fluid fills the scrotum, which is the sac under the penis that contains the testicles. Fluid can surround one or both testicles, causing swelling in the scrotum. Although the condition is much more common in baby boys, it may also occur in adult men.
Normal Scrotal Anatomy (left). Scrotal Anatomy with Hydrocele (right)
About 10% of newborn male infants have a hydrocele, which often clears up without any particular treatment within the first year of life. Hydroceles occur in only about 1% of adult men, and will often disappear on their own within the first 6 months.
Before birth, the testicles develop near the kidneys. By the time of birth, the testicles normally drop from their position inside the abdomen into the scrotum through a tunnel of muscles called the inguinal canal. If the peritoneal sac in the canal is reopened, fluid may leak from the belly into the scrotum and cause a hydrocele. If there is some inflammation in the cell linings of the sac surrounding the testicles, a hydrocele can result. Other causes of hydrocele include:
One side or both sides of the scrotum become swollen and feels heavy, like a water-filled balloon. In most cases an adult hydrocele is painless. However, the swelling of the scrotum may cause some discomfort. If pain is present, this could mean that more serious conditions including infection or testicular torsion (twisting of the testicle/cord) are present. You should contact a doctor right away if there is pain.
A doctor can diagnose a hydrocele through a combination of tests and observations, including:
There are no drugs available to treat adult hydrocele, although pain medication may help relieve any discomfort.
Surgery may be needed to repair/drain a hydrocele if it causes pain, if there might be an infection, or if the hydrocele becomes too large. A large hydrocele can become embarrassing or threaten the normal functioning of other structures in the scrotum. The doctor also may suggest surgery if the scrotal ultrasound shows something more than a simple hydrocele. In this case, the doctor would remove tissue from the hydrocele and send it to a lab for diagnosis.
Surgery for a hydrocele involves making a cut in the scrotum, or in the groin area near the scrotum, in order to drain out the accumulated fluid. This procedure can usually be done at an outpatient surgical center using a local anesthetic or under light general anesthesia. It considered a minor surgery and the patient goes home the same day.
The use of a needle to drain out fluid is no longer as common a procedure as it was in the past. However, it may still be used in cases of patients with heart problems or who are taking blood thinners.
The best protection against adult hydrocele is to keep the testicles and scrotum free of injury. For example, if taking part in contact sports, use an athletic cup.
Although hydroceles are usually not a major health issue, you should tell healthcare professional about any abnormality or swelling in the scrotum. Another disease or condition may be causing or mimicking the abnormality.
It is possible that a hydrocele may return, even after surgery.
A hydrocele is normally not dangerous unless it becomes extremely large or the hydrocele fluid becomes infected. A hydrocele does not affect a man’s ability to father children.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 06/02/2017