A hydrocele is a fluid-filled sac surrounding a testicle that causes swelling in the scrotum. It is a common condition, particularly in newborns and older men, and is usually painless and non-cancerous.
Communicating Hydrocele:
Occurs when the processus vaginalis (a small passage between the abdomen and scrotum) fails to close after birth, allowing abdominal fluid to flow into the scrotum.
Common in infants and young boys.
The size of the swelling may change throughout the day.
Non-Communicating Hydrocele:
The processus vaginalis closes, but fluid remains trapped in the scrotum.
The size of the swelling remains constant.
More common in older men.
In Infants: Often due to incomplete closure of the processus vaginalis during development.
In Adults:
Injury or inflammation in the scrotum.
Infection (e.g., epididymitis or sexually transmitted infections).
Complications from surgery or radiation therapy.
Often, the cause is unknown (idiopathic).
Swelling in one or both sides of the scrotum.
Heaviness or discomfort in the scrotum.
Pain (if the hydrocele is large or associated with an infection or injury).
Physical Examination: A doctor may shine a light through the scrotum (transillumination) to confirm the presence of fluid.
Ultrasound: To rule out other conditions, such as a hernia or testicular tumor.
In Infants: Most hydroceles resolve on their own by age 1–2 as the processus vaginalis closes.
In Adults:
Small, asymptomatic hydroceles may not require treatment.
For larger or symptomatic hydroceles:
Aspiration: Draining the fluid with a needle (rarely done due to risk of recurrence or infection).
Surgery (Hydrocelectomy): Removal of the hydrocele sac, which is the most effective treatment.
If the scrotal swelling is painful, sudden, or rapidly increasing.
If there are signs of infection (e.g., redness, fever).
If the swelling persists beyond infancy.
Hydroceles are generally harmless but should be evaluated by a healthcare professional to rule out other serious conditions, such as hernias or testicular cancer.
