Hydrocele (pronounced hydro-seal) is a collection of clear or yellow fluid around the testicle within the scrotum. Many male newborns have small hydroceles present at birth, most of which will go away on their own within the first year and do not require surgery. Babies, toddlers or older children may develop hydroceles later on.
A hydrocele can form as a congenital process where fluid collects around the testicle as it descends from the abdomen into the scrotum prior to birth. Most of these will resolve on their own as the body reabsorbs the fluid. Hydroceles that are large in size, are noticed after infancy or are associated with a persistent connection between the abdomen and the scrotum will often require surgical correction. These kinds of hydroceles can be similar to inguinal hernias in their origin or become an inguinal hernia in the future.
Occasionally some type of inflammation or trauma at or around the testicle can cause a temporary hydrocele that can resolve on its own when the inflammation subsides.
A hydrocele is usually painless, but can cause some discomfort in older children and teenagers if they become large and heavy. Hydroceles are either labeled as non-communicating or communicating. Communicating hydroceles are similar to inguinal hernias, in that the fluid around the testicle can travel back and forth between the groin and/or abdomen and the scrotum. These can intermittently change in size. Fluid in non-communicating hydroceles is trapped around the testis, typically resulting in a stable size of the hydroceles.
Because they are made of fluid, hydroceles generally have a different texture than solid lesions of or around the testicle and will transilluminate or glow when a light is shined through the scrotal skin. Larger hydroceles sometimes can have a bluish appearance through the skin.
When there is difficulty telling the difference between a hydrocele and other scrotal lesions, a scrotal ultrasound can help determine the origin of scrotal swelling.
Most hydroceles in babies and younger children are repaired surgically through an inguinal (groin) incision since the anatomy is similar to an inguinal hernia. Younger infants (< 6 months of age) may require overnight admission to the hospital after this surgery but in general, this is an outpatient, same day surgery.
Adolescents and teenagers are more likely to have non-communicating hydroceles than are corrected through a scrotal incision. This is typically an outpatient surgery where the child can go home on the same day after the procedure.