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Hydrocele
Processus vaginalis; Patent processus vaginalis
A hydrocele is a fluid-filled sac in the scrotum .
Scrotum
The scrotum is a part of a male's body that is located behind the penis. The scrotum is the sac (pouch) that contains the testes, epididymis, and th...
Causes
Hydroceles are common in newborn infants.
During a baby’s development in the womb, the testicles descend from the abdomen through tube into the scrotum. Hydroceles occur when this tube does not close. Fluid drains from the abdomen through the open tube and gets trapped in the scrotum. This causes the scrotum to swell.
Most hydroceles go away a few months after birth. Sometimes, a hydrocele may occur with an inguinal hernia .
Inguinal hernia
A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the be...
Hydroceles may also be caused by:
- Buildup of the normal fluid around the testicle. This may occur because the body makes too much of the fluid or it does not drain well. (This type of hydrocele is more common in older men.)
- Inflammation or injury of the testicle or epididymis
Symptoms
The main symptom is a painless, swollen testicle , which feels like a water balloon. A hydrocele may occur on one or both sides.
Swollen testicle
Scrotal swelling is abnormal enlargement of the scrotum. This is the name for the sac surrounding the testicles.
Exams and Tests
You will have a physical exam. The health care provider will find that the scrotum is swollen, but not painful to the touch. Often, the testicle cannot be felt because of the fluid around it. The size of the fluid-filled sac can sometimes be increased and decreased by putting pressure on the abdomen or the scrotum.
If the size of the fluid collection changes, it is more likely to be due to an inguinal hernia.
Hydroceles can be easily seen by shining a flashlight through the swollen part of the scrotum. If the scrotum is full of clear fluid, the scrotum will light up.
You may need an ultrasound to confirm the diagnosis.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
Treatment
Hydroceles are not harmful most of the time. They are treated only when they cause infection or discomfort.
Hydroceles from an inguinal hernia should be fixed with surgery as soon as possible. Hydroceles that do not go away on their own after a few months may need surgery. A surgical procedure called a hydrocelectomy (removal of sac lining) is often done to correct the problem. Needle drainage does not work well because the fluid will come back.
Hydrocelectomy
Hydrocele repair is surgery to correct the swelling of the scrotum that occurs when you have a hydrocele. A hydrocele is the backup of fluid around ...
Outlook (Prognosis)
Simple hydroceles in children often go away without surgery. In adults, hydroceles usually do not go away on their own. If surgery is needed, it is an easy procedure with very good outcomes.
Possible Complications
Risks from hydrocele surgery may include:
- Blood clots
- Infection
- Injury to the scrotum
When to Contact a Medical Professional
Call your provider if you have symptoms of hydrocele. It is important to rule out other causes of a testicular lump .
Testicular lump
A testicle lump is swelling or a growth (mass) in one or both testicles.
Pain in the scrotum or testicles is an emergency. If you have pain and your scrotum is enlarged, seek medical help right away to prevent the loss of the testicle.
References
Barthold JS. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 132.
Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 545.
Kavoussi PK, Costabile RA. Surgery of the scrotum and seminal vesicles. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 37.
Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care . 2010;37:613-626. PMID: 20705202 www.ncbi.nlm.nih.gov/pubmed/20705202 .
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Male reproductive anatomy - illustration
The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.
Male reproductive anatomy
illustration
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Hydrocele - illustration
A hydrocele is a collection of fluid inside the area of the scrotum, surrounding the testicle. Hydroceles are common in newborn infants and normally resolve after a few months after birth. The main symptom is a painless, swollen testicle, on one or both sides, which feels like a water-filled balloon. Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they threaten the blood supply of the testicle.
Hydrocele
illustration
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Male reproductive anatomy - illustration
The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.
Male reproductive anatomy
illustration
-
Hydrocele - illustration
A hydrocele is a collection of fluid inside the area of the scrotum, surrounding the testicle. Hydroceles are common in newborn infants and normally resolve after a few months after birth. The main symptom is a painless, swollen testicle, on one or both sides, which feels like a water-filled balloon. Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they threaten the blood supply of the testicle.
Hydrocele
illustration
Review Date: 8/31/2015
Reviewed By: Jennifer Sobol, DO, urologist at the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
