A hydrocele is a collection of fluid in the testicular membrane that causes swelling in the scrotum.
Females can also experience hydroceles along the Knock Canal, but it is very rare.
About 10% of newborn males have a hydrocele, which usually disappears before the age of one year.
Enlarging can happen on one or the two sides of the scrotum. It does not cause pain but can be uncomfortable, especially when the swelling is significant.
Usually, a hydrocele does not cause any pain, and the only symptom is a swollen scrotum.
However, in adults, a hydrocele can be uncomfortable. The more fluid in the hydrocele, the heavier the scrotum feels. Some people find the swelling more annoying in the morning than in the evening.
If sudden pain or swelling in the scrotum occurs, especially after an injury to the scrotum, it is important to get medical help right away.
These symptoms can result from restricted blood flow in a twisted testicle (testicular torsion), which requires immediate treatment.
There are two types of hydrocele: connected and unconnected hydrocele.
A hydrocele is formed in infants when the inguinal ring is closed, but the fluid remains in the membrane of the testicles. The fluid is usually absorbed by the body within a year.
The inguinal ring rarely remains open, allowing fluid to pass back and forth between the abdomen and the membrane of the testicles. Doctors call this a continuous hydrocele. The size of the scrotal swelling can change, depending on a person’s activity levels and the amount of fluid present.
Conductive hydroceles are often associated with inguinal hernias.
The cause of the hydrocele depends on the age of the person.
As a male fetus grows during pregnancy, the testicles develop near the kidneys in the abdomen. By the end of a full pregnancy, they move to their usual position in the scrotum.
To allow the testicles to descend, the muscle lining of the scrotum (the inguinal ring) opens, forming a duct, or sac.
As soon as the testicles move to their usual position, the inguinal ring is closed. If the ring remains open or reopens, fluid can travel from the abdomen to the scrotum through this duct, and this causes a hydrocele.
Sometimes, babies are born before the testicles descend, which increases the chances of a hydrocele.
In older males, if the inguinal ring does not close or reopen, an attached hydrocele can form.
Hydrocele in adult males has several other possible causes, including:
A hydrocele is probably not going to be excruciating, yet it can cause an awkward sensation of greatness in the scrotum.
Hydroceles are not usually serious and will not affect fertility. In uncommon cases, it could be related with a basic testicular condition, like a contamination, cancer, or inguinal hernia.
People should seek a diagnosis from a doctor to rule out any other conditions.
When a person with a lump in the scrotum seeks treatment, a doctor will first ask questions to help determine the likely cause.
The doctor will perform a physical exam, which will include palpating the scrotum to confirm where the swelling is and how far it has spread.
The hydrocele is located in front of or below the testicle. The doctor will want to know if the scrotum is painful during the examination.
They can also check to see if the light is passing through the swelling in the scrotum. This test is called phototransduction.
If the swelling is filled with fluid, such as a hydrocele, light will pass through it. A solid mass, like a tumor, will not allow light to pass through.
Light radiation can be very useful in allowing doctors to determine the cause of a swollen scrotum, but some other steps can help them make a definitive diagnosis.
For example, the doctor may want to order another investigation, such as an ultrasound, if he or she has any doubts about the underlying cause of the swelling.
In rare cases, exploratory surgery may be the only way to identify the problem responsible for these symptoms.
Most children and infants with hydrocele will not need any treatment, as the condition will clear up over time.
Parents and caregivers should check the scrotum every now and then and call the doctor if the swelling becomes very significant, or if the infant is in pain.
For people with very large and uncomfortable hydroceles, surgery to remove them may be the best option.
Another treatment choice is to deplete the hydrocele utilizing needle goal. In this procedure, a doctor inserts a long needle into the cyst to withdraw fluid. They can then inject chemicals into the hydrocele to prevent it from refilling with fluid (sclerotherapy). This treatment is best for adults who are at risk of complications during surgery.