A hydrocele is a build-up of fluid in the membrane that surrounds the testicle.
Types of hydrocele include:
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A communicating hydrocele is more common in infants and children. It occurs during fetal development. Testicles develop in the abdomen. They eventually move into the scrotum through a small channel. This channel should close after the testicles pass through it. When the channel does not close, fluid can pass from the abdomen into the membrane covering the testicle.
A noncommunicating hydrocele is more common in adults. It may be caused by an injury or infection that causes fluid build-up. It can also be a complication of surgery. In some cases, the cause is unknown.
Factors that may increase the chances of a hydrocele:
A hydrocele may not always cause symptoms. When they do appear, a hydrocele may cause:
You will be asked about your symptoms and medical history. A physical exam will be done. A hydrocele is usually diagnosed by physical exam. The doctor may want to do tests to confirm a cause or rule out other conditions.
Tests may include:
Treatment options include:
A communicating hydrocele generally goes away on its own during the first year of life. A noncommunicating hydrocele may also resolve on its own or with treatment of a related condition. Watchful waiting is simple monitoring for any changes with treatment if the problem worsens or does not go away.
Fluid may be removed with a needle. It may be done for a large hydrocele that causes discomfort or obstruction. Aspiration may need to be done more than one time because fluids can return.
For adults with a hydrocele, fluid aspiration may be followed by sclerotherapy. A needle is inserted into the same area with a sclerosing agent. The sclerosing agent causes scar tissue in the channel which blocks the flow of fluid.
A hydrocelectomy may be advised if the hydrocele:
During a hydrocelectomy to treat a noncommunicating hydrocele, an incision is made into the scrotum (or groin area). The fluid is drained, and the hydrocele sack is removed. During a hydrocelectomy to treat a communicating hydrocele, the incision is made in the groin, the fluid is drained, and the hydrocele sack is removed. Surgery usually corrects the problem without recurrence.
Some hydroceles cannot be prevented. However avoiding testicular trauma, such as by wearing protective gear during contact sports, may reduce the chances of developing some types of hydroceles.
Healthy Children—American Academy of Pediatrics
Urology Care Foundation
Canadian Urological Association
The College of Family Physicians of Canada
Hydrocele. Patient website. Available at: https://patient.info/doctor/hydrocele. Updated February 26, 2016. Accessed March 8, 2018.
Hydrocele in adults and adolescents. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116012/Hydrocele-in-adults-and-adolescents. Updated January 22, 2018. Accessed March 8, 2018.
Hydrocele in infants and children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T913127/Hydrocele-in-infants-and-children. Updated October 2, 2017. Accessed March 8, 2018.
Painless scrotal mass. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/painless-scrotal-mass. Updated March 2017. Accessed March 8, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 10/3/2016