What is Hydrocele

Hydrocele is a collection of fluid in the loose pouch of skin that holds the testicles (scrotum). This may happen because:

• The amount of fluid produced in the scrotum is not absorbed by the rest of the body.
• Fluid from the abdomen fills the scrotum. Normally, the testicles develop in the abdomen then move (drop) into to the scrotum before birth. The tube that the testicles travel through usually closes after the testicles drop. If the tube does not close, fluid from the abdomen can fill the scrotum. This is less common in adults.

What are the causes?

The cause of a hydrocele in adults is usually not known. However, it may be caused by:

• An injury to the scrotum.
• An infection (epididymitis).
• Decreased blood flow to the scrotum.
• Twisting of a testicle (testicular torsion).
• A birth defect.
• A tumor or cancer of the testicle.

What are the signs or symptoms?

A hydrocele feels like a water-filled balloon. It may also feel heavy. Other symptoms include:

• Swelling of the scrotum. The swelling may decrease when you lie down. You may also notice more swelling at night than in the morning.
• Swelling of the groin.
• Mild discomfort in the scrotum.
• Pain. This can develop if the hydrocele was caused by infection or twisting. The larger the hydrocele, the more likely you are to have pain.

How is this diagnosed?

This condition may be diagnosed based on:

• Physical exam.
• Medical history.

You may also have other tests, including:

• Imaging tests, such as ultrasound.
• Blood or urine tests.

How is this treated?

Most hydroceles go away on their own. If you have no discomfort or pain, your health care provider may suggest close monitoring of your condition (called watch and wait or watchful waiting) until the condition goes away or symptoms develop. If treatment is needed, it may include:

• Treating an underlying condition. This may include using an antibiotic medicine to treat an infection.
• Surgery to stop fluid from collecting in the scrotum.
• Surgery to drain the fluid. Options include:
  • Needle aspiration. A needle is used to drain fluid. However, the fluid buildup will come back quickly.
  • Hydrocelectomy. For this procedure, an incision is made in the scrotum to remove the fluid sac.

Follow these instructions at home:

• Watch the hydrocele for any changes.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You notice any changes in the hydrocele.
• The swelling in your scrotum or groin gets worse.
• The hydrocele becomes red, firm, painful, or tender to the touch.
• You have a fever.

Get help right away if you:

• Develop a lot of pain, or your pain becomes worse.

Summary

• A hydrocele is a collection of fluid in the loose pouch of skin that holds the testicles (scrotum).
• Hydroceles can cause swelling, discomfort, and sometimes pain.
• In adults, the cause of a hydrocele usually is not known. However, it is sometimes caused by an infection or a rotation and twisting of the scrotum.
• Treatment is usually not needed. Hydroceles often go away on their own. If a hydrocele causes pain, treatment may be given to ease the pain.