A hydrocele is a collection of fluid in the scrotum. Most develop for no apparent reason, are harmless and can be left alone. If needed, a small operation can usually cure the problem. In a small number of cases, a hydrocele is due to an underlying problem with a testicle (testis).
A hydrocele can occur on one side or on both sides of the scrotum but most commonly occur on the right side. Apart from the scrotal swelling associated with a hydrocele, other signs characteristic of the condition include:
- A bluish discolouration of the skin
- Fluctuation in the size of the swelling (mainly in infants)
- The area of the hydrocele is clearly defined
The doctor will carefully examine the scrotal swelling. Shining a light on the area will help differentiate a hydrocele from others causes of swelling, such as an inguinal hernia. With a hydrocele the presence of fluid will cause the scrotum to light up when a light is shone on the area (transillumination).
In adolescents and adults, further diagnostic tests such as blood tests and ultrasound scanning may be recommended.
In adolescents and adults treatment may not be required if the collection of fluid is small, the testes can be examined easily, and the amount of fluid remains constant. Treatment may be recommended if it is causing discomfort or embarrassment.
A hydrocele can be treated by draining the fluid with a needle (aspiration) or by a minor surgical procedure. To drain the collection of fluid, a needle is inserted into the area affected and the fluid is removed. Surgical removal of the hydrocele (hydrocelectomy) may be recommended in cases where the hydrocele is large and painful or where it has recurred after aspiration.
This is a minor surgical procedure performed and can be on a day stay basis. During surgery a small incision is made in the scrotum. The collection of fluid is then drained and the membranes involved are removed. The incision is closed with small stitches. Surgery usually ensures permanent resolution.