Communicating Hydrocele

Overview

What is a communicating hydrocele?

A communicating hydrocele is a common condition that affects males. A hydrocele is a collection of fluid in the scrotum (sac located under the penis). More than one in 10 male infants has a hydrocele at birth.

A communicating hydrocele is a hydrocele that has an opening referred to as a “communication” into the abdominal cavity. The opening allows abdominal fluid to pass into the scrotum. A non-communicating hydrocele is less serious than a communicating hydrocele. A non-communicating hydrocele usually remains the same size or has a very slow growth.

If a communicating hydrocele does not go away on its own and is not treated, it can lead to an inguinal hernia. In this condition, part of the intestine or intestinal fat pushes through an opening (inguinal canal) in the groin area.

Symptoms and Causes

What causes a communicating hydrocele?

A communicating hydrocele occurs while the baby is in the womb. A membrane extends through the inguinal canal in the abdominal wall into the scrotum. The thin membrane is called the processus vaginalis. If it remains open, fluid flows back and forth from the abdominal cavity and the scrotum.

A non-communicating hydrocele in a boy or adult male can be caused by an injury to the scrotum.

What are the symptoms of a communicating hydrocele in an infant?

If a baby has a communicating hydrocele, his scrotum will be swollen or enlarged. The size of the scrotum can vary throughout the day. If the baby lies down or sleeps, the swelling often goes down. In most cases, communicating hydroceles do not cause an infant any pain. If a hydrocele is non-communicating, it does not change in size.

Diagnosis and Tests

How is a communicating hydrocele diagnosed?

A pediatrician will usually diagnose a communicating hydrocele by a visual examination. He or she may shine a light through the scrotum to view any fluid surrounding a testicle.

An ultrasound of the scrotum may also be prescribed if the area appears very swollen or feels hard to the touch. This can also rule out other possible causes of the swelling.

Management and Treatment

How is a communicating hydrocele repaired?

Communicating hydroceles often disappear within the first year of life without any treatment. In most cases, your child’s doctor will suggest that you first watch the area and have your child checked every few months. If the hydrocele does not go away within 6 to 12 months, it may need to be surgically repaired to prevent more serious complications.

Surgery to repair a communicating hydrocele is a simple procedure that can usually be done on an outpatient basis.

Your child will need anesthesia for the surgery. Once he is asleep, a small incision (about 2 cm) is made in the folded skin of the groin. The surgeon then empties the fluid from the hydrocele and the thin processus vaginalis membrane is closed.

Outlook / Prognosis

What is the recovery period after surgery for communicating hydrocele?

Most infants will feel fine by the day following surgery for a communicating hydrocele. The doctor may prescribe oral pain medicine. He or she will advise you on the proper care following surgery.

Your baby will be able to eat and play normally as soon as he is able. However, for a period of 4 weeks, he should not straddle toys, climb, or do other very physical activities that could injure the groin area. You can bathe him two days after surgery.

Minor swelling around the incision area is normal. However, you should call the doctor if your baby has a fever, excessive swelling, redness, bleeding, or increasing pain.

Living With

When should I call the doctor about communicating hydrocele?

Call the doctor if you notice any of the following. These could be signs that part of an intestine has entered the scrotum along with abdominal fluid:

  • There is swelling around your infant’s scrotum.
  • Your infant seems to be having pain in his scrotum.
  • He seems to be nauseated.
  • Your infant is vomiting.

Last reviewed by a Cleveland Clinic medical professional on 09/23/2016.

References

  • NIH. Infant communicating hydroceles--do they need immediate repair or might some clinically resolve? (http://www.ncbi.nlm.nih.gov/pubmed/20223325) Accessed 8/11/2016.
  • American Urological Association. What are hydroceles and inguinal hernias? (http://www.urologyhealth.org/urologic-conditions/hydroceles-and-inguinal-hernia) Accessed 8/11/2016.
  • Medline Plus. Hydroceles (http://medlineplus.gov/ency/article/000518.htm) Accessed 8/11/2016.

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