What Is a Hydrocele?
A hydrocele is a swelling in the scrotum, the thin sac that holds the testicles. It happens when too much fluid builds up inside. The condition is most common in newborns, though it can happen at any age.
It may sound or look serious, even painful, but it won’t hurt your baby. It might go away on its own, though you should still see the doctor about it.
About 10 percent of infants have a hydrocele, and they often go away within the first year without any treatment.
About 1 percent of adults are affected by hydroceles.
Hydrocele vs. variocele
When you have a variocele, a vein in your scrotum is enlarged. It's similar to a varicose vein in your leg. Varioceles can be painful and may cause infertility. But if your variocele doesn't bother you, you may not need treatment.
Hydrocele Causes
Hydrocele in infants
A hydrocele can start before your baby is born. The testicles grow inside their belly and then move down into their scrotum through a short tunnel. A sac of fluid goes with each testicle. Usually, the tunnel and the sac seal off before birth, and the baby’s body absorbs the fluid inside. When this process doesn’t go as it should, they can get a hydrocele.
There are two types of hydrocele:
- A noncommunicating hydrocele happens when the sac closes like normal, but the baby's body doesn’t absorb the fluid inside it.
- A communicating hydrocele happens when the sac doesn’t seal. With this type, the scrotum may swell more over time.
Babies born prematurely are more likely to have a hydrocele.
Hydrocele in adults
In older children, teens, and adults, an injury to the scrotum can cause a hydrocele. Inflammation also can cause a hydrocele. Your scrotum might become inflamed because you have an infection in your testicle or in the small tube behind each testicle.
Rarely, a hydrocele might occur with testicular cancer.
For older children and adults, a few steps can make a hydrocele less likely:
- Wear protective gear for your scrotum while playing sports.
- Keep your scrotum clean -- this reduces the chance of infection.
- If you think you have an infection, see a doctor right away for treatment.
- If you suffer trauma to your scrotum, see a doctor.
- Manage chronic conditions such as heart disease and diabetes, which can increase your risk for hydroceles.
Hydrocele Symptoms
A hydrocele doesn’t hurt. The only symptom you’ll notice is that one or both of the baby’s testicles look swollen. Even if they are not in pain, you should see the pediatrician to make sure they don’t have other health problems that are causing the swelling, such as an infection, a tumor, or a hernia.
The swelling from a noncommunicating hydrocele doesn’t change in size. A communicating hydrocele can get bigger during the day, and if you gently squeeze it, the fluid will move out of the scrotum and into the belly.
Hydrocele Diagnosis
When you take your baby to the doctor, they’ll do a physical exam. They’ll check the scrotum for fluid and tenderness, and they'll shine a light through it to see if there’s fluid around the testicle.
Your doctor also will make sure your baby doesn’t have a hernia.
Your baby may also get a blood test and an imaging test. A hydrocele ultrasound can make sure nothing else is causing the swelling.
Hydrocele Treatment
A hydrocele usually goes away on its own before a baby's first birthday. If it doesn’t, or if it gets bigger, your doctor will refer them to a specialist called a urologist.
If your baby has a communicating hydrocele, the pediatrician will usually recommend surgery without waiting for it to go away.
The doctor can remove a hydrocele. Hydrocele surgery is called a hydrocelectomy.
Your baby will get a local numbing agent or be put under anesthesia. Then, a surgeon makes a cut in their scrotum or lower belly. The surgeon then drains the fluid and sews the sac closed. Once it’s finished, your baby can go home the same day.
In the days after surgery, you’ll need to keep the area clean and dry. The doctor and team will show you how to care for your baby as they heal.
After a few days, you may need to take them back to the doctor to make sure they are healing well.
Hydrocele aspiration
Another type of treatment is called an aspiration. The doctor inserts a long needle into the hydrocele to remove fluid. They might also inject a drug to stop fluid from building up again. A hydrocele can come back after needle aspiration. This procedure is an option for adults who don't want to have surgery, aren't healthy enough for surgery, or want immediate results. It carries a risk of infection.
Hydrocele Complications
Most of the time, a hydrocele isn't serious and doesn’t usually affect fertility later on in life. But sometimes, having a hydrocele might mean there’s a more serious problem with the testes and potential complications. These include:
- Infection or tumor. These could reduce sperm production or function.
- Trauma
- Inguinal hernia. This happens when a loop of intestine sticks out through a weak spot in the abdominal wall and gets trapped. This can cause dangerous complications.
Takeaways
When you have a hydrocele, your scrotum becomes swollen because of a fluid buildup. In babies, hydroceles can form before birth. Sometimes they disappear on their own, but you should have your doctor check it. In older children and adults, hydroceles can form because you've injured your scrotum or because you have inflammation in your testicle or in nearby structures. A doctor can remove a hydrocele with a relatively simple surgery. You also can have the fluid removed by a needle in a procedure called aspiration. But hydroceles drained this way may come back.
Hydrocele FAQs
Can a hydrocele burst?
Yes, a hydrocele can burst, although this is rare. When this happens, it's usually because an untreated hydrocele has become very large, or the hydrocele has had pressure placed on it.
Can you squeeze fluid out of a hydrocele?
You can't force fluid out of your baby's body by squeezing a hydrocele. But if the hydrocele is the communicating type, you can push the fluid back up into the abdominal cavity with a gentle squeeze.
Can a hydrocele cause infertility?
If a hydrocele is your baby's only symptom, research shows that it probably won't affect fertility in the future.
What is hydrocele support therapy?
If your baby has a hydrocele, you should see your doctor for the best treatment plan.
If you're an adult with a hydrocele, there are a few things you can try that might help any symptoms you're feeling:
- Wearing briefs, compression shorts, or an athletic supporter might reduce swelling and make you more comfortable.
- Avoid things that might cause strain, such as heavy lifting or sports.
- Applying a cold compress to the scrotum might reduce swelling.
