Topic Overview
What is a hydrocele?
A hydrocele is a painless buildup of watery fluid around one or
both
testicles that causes the
scrotum or groin area to swell. Although this swelling
may be unsightly and uncomfortable, it usually is not painful and generally is
not dangerous. Although hydroceles are common in newborns, they can also occur
at any age in later life.
What causes a hydrocele?
The cause of most hydroceles is unknown.
Hydroceles in newborns may mean there is an opening between the
abdomen and the scrotum. Normally such openings close before birth or shortly
after.
Hydroceles that appear later in life may be caused by an injury
or surgery to the scrotum or groin area, by inflammation or infection of the
epididymis or testicles. In rare cases, hydroceles may
occur with cancer of the testicle or the left kidney. This type of hydrocele
can occur at any age but is most common in men older than 40.
What are the symptoms?
Often a hydrocele does not cause symptoms. You may notice
enlargement of your scrotum. Symptoms, when present, can include pain,
swelling, or redness of the scrotum or a feeling of pressure at the base of the
penis.
How is a hydrocele diagnosed?
A hydrocele is usually diagnosed by examining the scrotum, which
may appear enlarged. As part of the examination, your health professional will
shine a light behind each testicle (transillumination) to check for solid
masses that may be caused by other problems, such as cancer of the testicle.
Because hydroceles are filled with fluid, light will shine through them
(transillumination). Light will not pass through solid masses that may be
caused by other problems, such as cancer of the testicle. An
ultrasound may be used to confirm the diagnosis of a
hydrocele.
How is it treated?
Hydroceles are not usually dangerous and are treated only when
they cause pain or embarrassment or when they decrease the blood supply to the
penis (rare). Treatment is not usually needed if a hydrocele does not change in
size or gets smaller as the body reabsorbs the fluid. Hydroceles in men younger
than 65 may go away by themselves, but hydroceles in older men do not usually
go away.
Fluid can also be removed from a hydrocele with a needle
(aspiration). However, hydroceles that are aspirated often return, and surgery
may then be needed. Aspiration is recommended only for men who are not
physically able to have surgery because the risk of infection and
recurrence.
If the hydrocele gets larger or causes discomfort, surgery to
remove the hydrocele (hydrocelectomy) may be needed.