Hydrocele

Overview

A hydrocele is a condition where the fluid accumulates in the thin sac that surrounds the testicle resulting in the enlargement of the scrotum. Hydroceles are a common problem in infant males but can also occur in older boys and men, resulting from trauma or injury around the scrotum.

Hydroceles are usually not painful or harmful and do not require any treatment. In babies, a hydrocele typically resolves on its own by age 1. However, immediate consultation is recommended for proper diagnosis and treatment if there is scrotal swelling.

Symptoms

Hydroceles usually do not cause any pain. The common symptoms may include:

• Swelling in one or both testicles
• Feeling of heaviness in scrotum due to swelling
• Changes in the size of the scrotum (smaller or bigger)
• Pain, when the scrotum becomes larger

It is recommended to consult a healthcare provider when experiencing any of the symptoms. Hydrocele in babies usually heals on its own. However, if the symptoms progress or do not resolve after a year, revisit your doctor for proper assessment and to rule out any other reasons for inflammation that may require treatment.

If you experience any of these symptoms, get emergency medical attention.

• Sudden, strong pain in a testicle
• Swelling and redness of the scrotum

These signs and symptoms can be caused by other diseases, including testicular torsion, whereas the testicle is twisted resulting in an obstructed blood supply. To preserve the testicle, this must be addressed immediately.

In some cases, a hydrocele may be accompanied with an inguinal hernia. This occurs when the tissue in the abdomen floor have weakens which allows an intestinal loop to expand into the scrotum.

Causes

Hydrocele has two types:

• Communicating: A communicating hydrocele has an interaction with the fluids of the abdomen. It is caused by the failure of the vaginalis processes
• Non-communicating: A non-communicating hydrocele may be present at birth or develop years later for no apparent reason. The inguinal canal did close in this case, however, there is still excess fluid around the testicle in the scrotum.

The cause of hydroceles typically depends on the age of the male:

• Baby boys: Hydrocele is common in about 10% of male babies. It usually forms during the infant’s early development before birth. This happens when the testicles move from the growing baby’s abdominal wall into the scrotum. Each testicle is accompanied by a sac that allows fluid to surround the testicles. Each sac usually shuts, and the fluid is collected.

Most cases of hydrocele in babies resolve within a year without any medical intervention. Hydroceles affect only approximately 1% of adult males and usually go away on their own.

With communicating hydrocele, the sac stays open or does not fully close. If the scrotal sac is squeezed, fluid might return to the abdomen. Communicating hydroceles are frequently accompanied with inguinal hernia. With noncommunicating hydrocele, the fluid lingers after the sac shuts. The fluid is collected continuously throughout the first year of life.

• Older males: Although more common in babies, hydrocele can still form later in life. In adults, it can be caused by inflammation or injury in the scrotum or along the area. The swelling may be due to epididymitis, an infection in the coiled tube at the back of the testicles.

Risk factors

Hydrocele might not be a serious health concern, but it will require constant monitoring, especially in premature babies. Premature birth significantly increases one’s risk of developing a hydrocele. This condition is often present from birth. It affects at least 5% of male infants. [Text Wrapping Break]
In adult men, common risk factors include scrotal injury or irritation, usually caused by contact sports, and infection such as sexually transmitted infection (STI).