What is a hydrocele?
A hydrocele (say “HY-druh-seel”) is a buildup of watery fluid around one or both testicles. It causes the scrotum or groin area to swell.
A congenital hydrocele is one that a baby is born with. Hydroceles can also occur later in life for a number of reasons. This topic is about congenital hydroceles, which are common in male newborns.
The swelling from a hydrocele may look scary, but it is usually not a problem. It will probably go away by the time your baby is 2 years old.
What causes a congenital hydrocele?
A month or so before birth, a baby’s testicles move from the belly area down into the scrotum, along with a bit of the lining of the belly area. The lining shrivels up, leaving a small empty space around the testicles. This space normally closes up by the time a baby is 2 years old.
Sometimes fluid leaks into the space, filling it like a small water balloon. This is a hydrocele. When the space closes up and traps the fluid inside, it’s called a noncommunicating hydrocele. Usually, the body absorbs the fluid over time.
If the space doesn’t close up the way it should, the fluid moves back and forth between the scrotum and the belly area. This is called a communicating hydrocele. The swelling comes and goes. This problem is usually fixed with surgery to help prevent a hernia in the groin.
Another type of hydrocele is a hydrocele of the spermatic cord. It is located higher up in the scrotum. The fluid is usually absorbed within a few months and at the latest by age 1 or 2. A hydrocele of the cord may be mistaken for an inguinal hernia.
What are the symptoms?
The usual symptom is a swollen scrotum. The swelling does not hurt. If your child seems to be in pain, call the doctor. Pain may mean that your child has a hernia or other problem.
How is a congenital hydrocele diagnosed?
Doctors diagnose a congenital hydrocele during a physical exam that includes questions about the child’s health. The swelling is often easy to see, so the hydrocele is typically not hard to identify. But the doctor will want to rule out other conditions.
How is it treated?
Most of the time, all you need to do is watch for changes in the swelling. If the swelling gets bigger or if it comes and goes, tell your doctor.
Your child may need surgery to remove the fluid if:
- He still has the hydrocele at age 2.
- The swelling comes and goes.
- The swelling causes pain.
- The swelling gets worse.
If surgery is needed, the doctor or nurse will give your child medicine to make him or her sleep. A small cut (incision) will be made in the groin area. At the end of the surgery, the cut will be stitched up. The doctor may ask you if you want him or her to check the opposite groin area for a hydrocele or other problem during the same surgery. After surgery, you’ll need to care for the groin incision and watch for signs of infection.
Other Works Consulted
- Elder JS (2011). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1858–1864. Philadelphia: Saunders.
- Koski ME, et al. (2010). Infant communicating hydroceles—Do they need immediate repair or might some clinically resolve? Journal of Pediatric Surgery, 45(3): 590–593.
- Zderic SA, Lambert SM (2010). Developmental abnormalities of the genitourinary system. In CA Gleason, SU Devaskar, eds., Avery’s Diseases of the Newborn, 9th ed., pp. 1191–1204. Philadelphia: Saunders.
Current as of: December 19, 2018
Author: Healthwise Staff
Medical Review:John Pope, MD, MPH – Pediatrics & Adam Husney, MD – Family Medicine & Peter Anderson, MD, FRCSC – Pediatric Urology