A hydrocele is a swelling in the scrotum that occurs due to fluid accumulation in the sheet covering the testicles. It is a common occurrence in newborns and usually disappears by the age of 1 year. However, it can also occur later in life as a result of an injury to or within the scrotum.
More about hydrocele
Around 10% of male babies are born with a hydrocele. While most babies do not show symptoms of the condition and the condition resolves by itself, it requires medical intervention in some cases.
Types of a hydrocele
Depending upon the age when the hydrocele occurs, it can be of two types:
- Infantile: This is the more common type and occurs in newborn babies.
- Adult-onset: This type of hydrocele occurs in older boys and adult men, and can occur anytime during their lifetime.
Depending on whether the sac closes or not, hydroceles can be of two types:
- Communicating: In this type of hydrocele, the sac is not completely closed off, and this results in the fluid within the sac to move in and out.
- Non-communicating: In this type of hydrocele, the sac with the fluid is sealed-off completely, and the body does not absorb the fluid.
What are the symptoms of a hydrocele?
See your doctor if you or your child experiences scrotal swelling. It’s important to rule out other causes of the swelling that might require treatment. For example, a hydrocele might be associated with a weak point in the abdominal wall that allows a loop of intestine to extend into the scrotum (inguinal hernia).
A baby’s hydrocele typically disappears on its own. But if your baby’s hydrocele doesn’t disappear after a year or if it enlarges, ask your child’s doctor to examine the hydrocele again.
Get immediate medical treatment if you or your child develops sudden, severe scrotal pain or swelling, especially within several hours of an injury to the scrotum. These signs and symptoms can occur with a number of conditions, including blocked blood flow in a twisted testicle (testicular torsion). Testicular torsion must be treated within hours of the beginning of signs and symptoms to save the testicle.
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What are the complications of a hydrocele?
A hydrocele does not, by itself, mean that there is a serious problem. However, there can be a few complications that can arise or co-exist with a hydrocele:
- Inguinal hernia
- Rupture of the hydrocele
- Pyocele (fluid in the sac is replaced by pus)
- Haematocoele (fluid in the scrotal sac is replaced with blood)
- Calculi in the scrotum
- Testicular hernia
- Sexual dysfunction
What causes a hydrocele?
A hydrocele can develop before birth. Normally, the testicles descend from the developing baby’s abdominal cavity into the scrotum. A sac accompanies each testicle, allowing fluid to surround the testicles. Usually, each sac closes and the fluid is absorbed.
Sometimes, the fluid remains after the sac closes (noncommunicating hydrocele). The fluid is usually absorbed gradually within the first year of life. But occasionally, the sac remains open (communicating hydrocele). The sac can change size or if the scrotal sac is compressed, fluid can flow back into the abdomen. Communicating hydroceles are often associated with inguinal hernia .
This condition is more common in preterm babies.
Apart from newborns, hydrocele is also common in men over the age of 40 years. The most common cause for this is fluid accumulation via the unclosed channels through which the testicles had descended. This condition can also occur as a result of an injury or inflammation in the scrotum.
Risk factors associated with a hydrocele
There are a few risk factors that result in the development of a hydrocele. These risk factors vary for babies and adult men. In the case of babies, risk factors cannot be determined as they are usually born with a hydrocele. However, risk factors that can result in the development of hydrocele after birth include:
- Injury or trauma
- Radiation therapy
How is a hydrocele diagnosed?
Before a hydrocele is treated, it needs to be diagnosed. The first diagnostic method for a hydrocele is by physical examination. Your doctor will palpate the scrotum to determine the type of swelling, if there is any pain, and try to palpate your testicles. If there is fluid accumulation in your scrotal sac, your doctor will not be able to feel your testicles.
Your doctor will shine a bright light source on the scrotum to confirm a hydrocele. The fluid in the scrotum will illuminate when a light is shined on it to confirm a hydrocele. However, if your scrotal swelling is due to a growing mass of tissue as seen in cancer, no illumination will be seen.
Blood and urine tests to help determine if you or your child has an infection, such as epididymitis
Ultrasound to help rule out hernia, testicular tumor or other causes of scrotal swelling
How is a hydrocele treated ?
Once a hydrocele has been confirmed, the next step is to treat it. In case your newborn infant is suffering from the condition, then his hydrocele should just resolve over a few months to a year. In case your child’s hydrocele doesn’t go away or enlarges, you must promptly visit a urologist.
In adults, a hydrocele usually resolves within six months. However, in many cases where it does not resolve by itself, it causes pain, or the swelling increases, you may be advised surgery.
The surgery for a hydrocele is performed under general anesthesia, and you will usually be discharged on the same day or the next. Surgery is usually warranted in case of a communicating hydrocele.
Another less invasive method to treat a hydrocele is a needle aspiration wherein all the fluid is aspirated from the swelling. This method is chosen for men who are at risk of complications in case surgery is performed.
A hydrocele is not a harmful or life-threatening health condition. It is easy to diagnose and easy to treat, with minimal damage to your body or reproductive life. However, it is always recommended to visit your doctor to rule out other harmful causes of scrotal swellings.
Frequently Asked Questions (FAQs)
- Is hydrocoele the same as hernia?
It is common to confuse a hydrocele with a hernia, but they are different conditions. A hydrocele is the collection of fluid in the scrotum surrounding the testicles. However, an inguinal hernia is the protrusion of abdominal contents into the inguinal canal in the scrotum.. Also, the two conditions need to be diagnosed clearly as their treatment is different too.
- How long does a hydrocele surgery take?
Hydrocele surgery is usually performed on an outpatient basis and takes about 30 minutes. Based on your baby’s condition, they may be discharged on the same day or the next. However, they will need some care at home for a few more days until they recover completely.
- Does a hydrocele recur?
Hydroceles rarely recur after surgery. However, some hydroceles that are large tend to recur even after surgery. These cases need to be treated surgically if it recurs within a year.