A hydrocele is a painless
buildup of watery fluid around one or both
testicles that causes the
scrotum or groin area to swell. This swelling may be
unsightly and uncomfortable, but 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. See a picture of a
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. Or
they can be caused 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.
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.
A hydrocele is
usually diagnosed by an exam of the scrotum, which may appear enlarged. As part
of the exam, your doctor will shine a light behind each testicle
(transillumination). This is to check for solid masses that may be caused by
other problems, such as cancer of the testicle. Hydroceles are filled with
fluid, so 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
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).
But 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 of the risk of infection and recurrence.
hydrocele gets larger or causes discomfort, surgery to remove the hydrocele
(hydrocelectomy) may be needed.
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Other Works Consulted
Barthold JS (2012). Abnormalities of the testis and scrotum and their surgical management. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 4, pp. 3557–3596. Philadelphia: Saunders.
December 28, 2012
E. Gregory Thompson, MD - Internal Medicine
& Christopher G. Wood, MD, FACS - Urology, Oncology
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