A communicating hydrocele is a collection of fluid in the scrotum from an opening into the abdominal cavity. A failure in the membrane between the abdominal cavity and scrotum causes the scrotum to swell. It usually goes away within a year, but it may require surgery.
A communicating hydrocele is a type of hydrocele.
A hydrocele is a fluid-filled sac surrounding your testicle that causes swelling in your scrotum (the pouch that holds your testes, or testicles).
A communicating hydrocele has an opening (communication) to your abdominal cavity. Your abdominal cavity is a large, hollow space in your body that contains many vital organs, including your stomach, small and large intestines, kidney, bladder and liver, as well as abdominal fluid. The communication allows abdominal fluid to pass into your scrotum, which causes the swelling.
A communicating hydrocele is more serious than a non-communicating hydrocele. A non-communicating hydrocele usually remains the same size or has very slow growth. A communicating hydrocele can change in size throughout the day. It may become very large and uncomfortable.
If a communicating hydrocele doesn’t go away on its own or doesn’t receive treatment, it can cause an inguinal hernia. If you have an inguinal hernia, part of your intestine or intestinal fat pushes through an opening (inguinal canal) in the groin area.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Communicating hydroceles commonly affect newborn boys or babies assigned male at birth (AMAB). However, they may also develop in adolescent and adult males and people AMAB, usually with a hernia.
Communicating hydroceles are very common. Nearly 50% of all newborn boys have communicating hydroceles, but they usually go away on their own without treatment by about 12 months of age.
A communicating hydrocele usually doesn’t cause pain. However, you may notice swelling on one side of the scrotum. The swelling may reduce in size while lying down or sleeping. It may increase with activity.
It depends. In newborns, a communicating hydrocele often gets better without treatment within a year. If it doesn’t improve on its own, you may need a hydrocelectomy.
If your child has communicating hydrocele, symptoms may include:
In older children and adults, symptoms may include the above symptoms, as well as:
A communicating hydrocele may feel like a soft, small water balloon in your scrotum.
A communicating hydrocele occurs while the fetus is in utero (in a birthing parent’s uterus, before birth). A thin membrane (processus vaginalis) extends through the inguinal canal in the abdominal wall into the scrotum. If the processus vaginalis remains open, fluid flows back and forth from the abdominal cavity and the scrotum, like waves at a beach.
Non-communicating hydroceles in children and adults usually occur as a result of an injury to the scrotum.
A healthcare provider can usually diagnose a communicating hydrocele through a physical examination. They may shine a light through your or your child’s scrotum to look at any fluid that surrounds a testicle.
Sometimes, a provider may order an ultrasound if the scrotum appears very swollen or feels hard to the touch. An ultrasound is a painless imaging test that can also rule out other possible causes of swelling, such as testicular cancer.
Communicating hydroceles often disappear within the first year of life without any treatment. Your child’s pediatrician will usually suggest that you keep an eye on the area and schedule regular checkups every few months.
If the communicating hydrocele doesn’t go away within a year, your child may need a hydrocelectomy. A hydrocelectomy is a surgical procedure that repairs a hydrocele. A surgeon will make a small (about 2 cm) incision in the groin, drain the fluid and close the processus vaginalis.
It’s an outpatient procedure, which means your child can go home the same day as their procedure.
There aren’t any medications available to treat a communicating hydrocele.
You may relieve mild pain with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol®). Not everyone can take NSAIDs, so it’s a good idea to check with a healthcare provider before you take them.
Recovery times may vary, but most infants start to feel better a few days after a hydrocelectomy. Your baby will be able to eat and play, but they should avoid straddling toys, climbing or doing any other physical activities that could injure their groin area for at least two to three weeks.
Minor swelling around the incision is normal. Your child’s healthcare provider may prescribe oral pain medication and give you instructions on how to manage discomfort.
Call their provider if your child has:
There’s nothing you can do to prevent a communicating hydrocele in your baby.
Hydroceles sometimes accompany a hernia in children and adults. You can help prevent a hernia by:
The outlook for a communicating hydrocele is good. In many cases, it goes away on its own without treatment. If surgery is necessary to correct a communicating hydrocele, the pain usually goes away within a few days, and you or your child can return to normal physical activities in a few weeks.
Call a healthcare provider if you notice any of the following symptoms. They could be signs that part of an intestine and/or abdominal fluid has entered the scrotum.
A communicating hydrocele has contact with the fluids in your abdominal cavity because the processus vaginalis is open. It may change size as fluid moves from the abdominal cavity to the scrotum.
In a non-communicating hydrocele, the processus vaginalis is closed. However, there’s still extra fluid around a testicle in your scrotum. It usually stays the same size or grows very slowly.
A note from Cleveland Clinic
Talk to a healthcare provider if you notice swelling or anything else unusual on or around your child’s scrotum. It’s important to have a provider check it out because it may be a communicating hydrocele, or it may be a different condition. If your child has a communicating hydrocele, it often goes away without treatment within the first year of your child’s life. However, the outlook is very good if surgery is necessary to correct it.
Last reviewed by a Cleveland Clinic medical professional on 03/02/2023.
Learn more about our editorial process.