What is hydrocele?

Hydrocele

A hydrocele is a buildup of fluid around one or both testicles that causes the scrotum or groin area to swell. The swelling may be unsightly or uncomfortable, but it is not painful.

Hydroceles may be present at birth (congenital) or may develop after birth (acquired). Congenital hydroceles usually go away by age 2. Acquired hydroceles may be caused by an injury to the groin area. Or the cause may be unknown. An acquired hydrocele can occur at any age, but it is most common in men older than 40.

If a hydrocele stays the same size or gets smaller as the body reabsorbs the fluid, generally no treatment is needed. If the hydrocele varies in size or gets bigger and becomes uncomfortable, surgery may be needed to remove the fluid.

What are the symptoms of a hydrocele?

Often a hydrocele does not cause symptoms. You may notice enlargement of your scrotum. Symptoms, when present, can include pain, swelling, or redness of the scrotum or a feeling of pressure at the base of the penis.

How is a hydrocele treated?

Hydroceles are not usually dangerous and are treated only when they cause pain or embarrassment or when they decrease the blood supply to the penis (rare). Treatment is not usually needed if a hydrocele does not change in size or gets smaller as the body reabsorbs the fluid. Hydroceles in men younger than 65 may go away by themselves. But hydroceles in older men do not usually go away.

Fluid can also be removed from a hydrocele with a needle (aspiration). But hydroceles that are aspirated often return, and surgery may then be needed. Aspiration is recommended only for men who are not physically able to have surgery because of the risk of infection and recurrence.

If the hydrocele gets larger or causes discomfort, surgery to remove the hydrocele (hydrocelectomy) may be needed.

How is a hydrocele diagnosed?

A hydrocele is usually diagnosed by an exam of the scrotum, which may appear enlarged. As part of the exam, your doctor will shine a light behind each testicle (transillumination). This is to check for solid masses that may be caused by other problems, such as cancer of the testicle. Hydroceles are filled with fluid, so light will shine through them. Light will not pass through solid masses that may be caused by other problems, such as cancer. An ultrasound may be used to confirm the diagnosis of a hydrocele.

What causes a hydrocele?

The cause of most hydroceles is unknown.

Hydroceles in newborns may mean there is an opening between the abdomen and the scrotum. Normally such openings close before birth or shortly after.

Hydroceles that appear later in life may be caused by an injury or surgery to the scrotum or groin area. Or they can be caused by inflammation or infection of the epididymis or testicles. In rare cases, hydroceles may occur with cancer of the testicle or the left kidney. This type of hydrocele can occur at any age but is most common in men older than 40.

Hydroceles

Three types of hydroceles

Normal: The fluid around the testicles is absorbed.

Noncommunicating hydrocele: The fluid stays around the testicles and is not absorbed.

Communicating hydrocele: The fluid flows back and forth between the scrotum and the abdomen.

Hydrocele of the cord: The fluid is located in the spermatic cord, between the scrotum and the abdomen.

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