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Medically reviewed by Last updated on Jul 4, 2022.

What is a hydrocele?

A hydrocele is a collection of fluid inside the scrotum. The scrotum holds the testicles. Hydroceles can occur in one or both sides of the scrotum and usually grow slowly. They are common in newborns. They also occur in children and adults. There are 2 kinds of hydroceles:

  • Simple hydrocele: A simple hydrocele can form at any age. This kind of hydrocele does not get bigger or smaller.
  • Communicating hydrocele: A communicating hydrocele can form at any age but is more common in infants and children. This kind of hydrocele gets bigger and smaller. Size changes are caused by fluid flowing through a tube from the abdomen into the scrotum. This occurs when the tube does not close as it should. The hydrocele may grow larger when you are active. It may shrink when you are at rest. A hydrocele may occur with a hernia. A hernia is when part of the intestine goes through a hole in the lining of the abdomen.

What causes a hydrocele?

Hydroceles usually do not have a specific cause. An injury to the scrotum may cause a hydrocele to form. The injury may be a blow to the scrotum during sports activity or a car crash. Hydroceles may also form after surgery or infection in the scrotum.

What are the signs and symptoms of a hydrocele?

A painless, swollen scrotum is the most common sign of a hydrocele. Your scrotum may feel sore and heavy from the swelling.

How is a hydrocele diagnosed?

Your healthcare provider will ask about your swollen scrotum and examine you. Tell your healthcare provider about any injury to your scrotum. He will apply gentle pressure to your scrotum to check whether the hydrocele shrinks. Your healthcare provider may order these or other tests:

  • Transillumination: Transillumination is when your healthcare provider shines a bright light on your scrotum. This helps him see the fluid inside your scrotum. Transillumination can help identify other problems, such as a hernia.
  • Ultrasound: An ultrasound uses sound waves to show pictures of your scrotum on a monitor. An ultrasound can help confirm the presence of a hydrocele and identify any other problems with the scrotum.

How is a hydrocele treated?

Your hydrocele will usually go away on its own. Your child's hydrocele will usually go away by the time he is 2 years old. The hydrocele will need to be removed if it does not go away, or gets very large. .

  • Support of scrotum: You may need to wear a fabric support device similar to a jock strap to decrease swelling.
  • Hydrocelectomy: Hydrocelectomy is surgery to remove your hydrocele. Healthcare providers make an incision in your scrotum or groin. During surgery for a simple hydrocele, a small incision is made, and the fluid is removed. During surgery for a communicating hydrocele, healthcare providers use stitches to close the tube. The stitches stop the flow of fluid from the hydrocele to the abdomen.
  • Needle aspiration: Healthcare providers put a needle through your scrotum and into your hydrocele. The fluid is drained from your scrotum through the needle.

What are the risks of a hydrocele?

  • Your hydrocele may not go away on its own. It may get bigger and cause pain or a heavy feeling. You may also have a hernia if you have a communicating hydrocele. If a hernia is not treated, it may cause pain and damage to your organs.
  • You may get an infection after surgery. You may have fertility problems after surgery. Surgery to remove the hydrocele may cause another simple hydrocele to form. After surgery or aspiration, the hydrocele may return.

When should I contact my healthcare provider?

  • Your scrotum is swollen.
  • The swelling gets bigger or does not go away.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

  • You have severe pain and swelling after an injury to the scrotum.

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