A hydrocele is a distinct, usually painless swelling in the scrotum caused by a pooling of fluid within the tubes that surround the testicles. It is usually found in newborns and males under the age of five, commonly due to an opening between the abdomen and the scrotum that never properly closed during development. It may also occur in men 40 years of age or older in response to scrotal trauma, as a side effect of surgery for varicocele repair, or for no known reason.
Types of Hydrocele
Compression of the scrotum indicates whether the hydrocele is noncommunicating, or cut off from the abdomen, or communicating where fluid flows to and from the abdomen.
Fluid in a noncommunicating hydrocele is usually absorbed by the body over time. Surgery is recommended when the hydrocele grows or has not resolved by the time the infant is 12-18 months old.
Symptoms of Hydrocele
It is common for a hydrocele to not cause any noticeable symptoms. However, it may sometimes cause pain, redness or swelling of the scrotum, occurring in one or both sides. The degree of swelling can vary quite a bit, with large hydroceles causing pain and discomfort in adults.
Diagnosis of Hydrocele
A hydrocele can be diagnosed through a physical examination by a doctor which may also include these tests:
Transillumination - Shining a light behind each testicle will detect if there are any unusual solid masses that may accompany the hydrocele, such as cancer.
Ultrasound - May be used to confirm the diagnosis of a hydrocele or a cancerous mass within a hydrocele.
Treatment of Hydrocele
Hydroceles are usually harmless and will often resolve themselves without medical treatment. However, in cases where hydroceles become irritating or painful, they may be removed or treated with the following procedures:
A hydrocelectomy results in the tunica vaginalis being drained and removed from the body, while the remaining tissue is sutured to prevent accumulation of more fluid.
This process is used only when surgery is considered too risky for the patient. It is the simple process of inserting a needle into the tunica vaginalis and draining the fluid.
Less than one percent of hydroceles that have been surgically removed return, while hydroceles that have been aspirated often return.