Hydrocele in Children

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

• 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 more common in infants.
• The amount of fluid produced in the scrotum is not absorbed by the rest of the body.

What are the causes?

This condition may be caused by:

• A congenital disability. This happens when:
  • The tube that connects the abdomen to the scrotum does not close at birth and remains open (communicating hydrocele). This allows fluid to pass back and forth between the scrotum and abdomen.
  • The tube that connects the abdomen to the scrotum closes at birth, but fluid gets trapped in the scrotum as the tube closes.
• Injury.
• Tissue that bulges into the scrotum (hernia).
• Twisting of the testicle (testicular torsion).
• Decreased blood flow to the testicles.
• Infection (rare).
• Tumor (rare).

What increases the risk?

Your child is more likely to develop this condition if:

• He was born before the due date (prematurely).
• He had a low birth weight.

What are the signs or symptoms?

The main symptom of this condition is swelling of the scrotum. The swelling is usually not painful. However, the larger the hydrocele, the more likely it is that your child may have pain.

How is this diagnosed?

This condition may be diagnosed based on:

• Physical exam.
• Medical history.
• Other tests, including:
  • Imaging tests, such as ultrasound.
  • Blood or urine tests.

How is this treated?

Hydroceles in newborns often go away on their own. If your child is not having discomfort or pain, the health care provider may suggest close monitoring of the condition (called watch and wait or watchful waiting) until it goes away or symptoms develop. If treatment is needed, it may include:

• Surgery. This may be needed to drain the fluid and to stop more fluid from collecting in the scrotum. If a hernia is present along with a hydrocele, surgery is usually needed.
• Treating an underlying condition. This may include using an antibiotic medicine to treat an infection.

Follow these instructions at home:

• Watch your child’s hydrocele carefully for any changes.
• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child was prescribed an antibiotic medicine, give it to him as told by the health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child’s swelling changes during the day.
• Your child has swelling in his groin.
• Your child has a fever.

Get help right away if:

• Your child vomits repeatedly.
• Your child cries constantly.
• Your child’s hydrocele seems painful.
• Your child’s swelling, either in the scrotum or groin, becomes:
  • Larger.
  • Firmer.
  • Red.
  • Tender to the touch.
• Your child who is younger than 3 months old has a temperature of 100°F (38°C) or higher.

Summary

• A hydrocele is a collection of fluid in the loose pouch of skin that holds the testicles (scrotum). The fluid causes the scrotum to swell.
• Hydroceles are common in newborn boys. In older children, the cause of a hydrocele is often not known. However, it may be the result of an infection, trauma, decreased blood flow to the testicles, or a hernia.
• 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.