Communicating Hydrocele

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.


What is a communicating hydrocele?

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.

How serious is a communicating hydrocele?

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.

What happens if a communicating hydrocele is not treated?

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.


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Who does a communicating hydrocele affect?

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.

How common are communicating hydroceles?

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.

How does a communicating hydrocele affect my body?

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.

In older children, a communicating hydrocele may indicate other problems, such as infection, testicular torsion or a tumor.

Does a communicating hydrocele need surgery?

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.


Symptoms and Causes

What are the symptoms of a communicating hydrocele?

If your child has communicating hydrocele, symptoms may include:

  • Swollen or enlarged scrotum.
  • Swelling that increases and decreases throughout the day.

In older children and adults, symptoms may include the above symptoms, as well as:

  • Inflammation.
  • Discomfort as your scrotum swells and gets heavy.
  • Pain as your scrotum increases in size.

What does a communicating hydrocele feel like?

A communicating hydrocele may feel like a soft, small water balloon in your scrotum.

What causes a communicating hydrocele?

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.


Diagnosis and Tests

How is a communicating hydrocele diagnosed?

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.

Management and Treatment

How do you treat a communicating hydrocele?

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.

What medications are used to treat a communicating hydrocele?

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.

How soon after treatment will my child feel better?

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:

  • Bleeding.
  • Increasing pain.
  • A fever.
  • Excessive swelling.
  • Skin discoloration (red, purple, brown or black).
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How can I prevent a communicating hydrocele?

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:

  • Increasing your core strength.
  • Using proper form when weightlifting or lifting other heavy objects. Don’t lift anything beyond your ability.
  • Maintaining a healthy body weight for you.
  • Eating a healthy amount of whole grains, fruits and vegetables to avoid constipation.

Outlook / Prognosis

What can I expect if I have a communicating hydrocele?

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.

Living With

When should I see a healthcare provider?

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.

  • Swelling or a lump around your infant’s scrotum or just above it.
  • Evident pain in your infant’s scrotum.
  • Your infant isn’t eating as much as usual.
  • Nausea and vomiting.
  • Pooping less than usual (decreased bowel movements).

What questions should I ask a healthcare provider?

  • How can you tell that my child has a communicating hydrocele?
  • If they don’t have a communicating hydrocele, what other condition do they have?
  • Do you think the communicating hydrocele will go away on its own?
  • How can I help my child stay comfortable if they have a communicating hydrocele?
  • Do you think my child needs a hydrocelectomy?
  • What are the advantages and risks of a hydrocelectomy?
  • How often should we schedule checkups?

Additional Common Questions

How do communicating and non-communicating hydroceles differ?

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.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 03/02/2023.

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