Hydrocele – Symptoms and Causes
Overview
A hydrocele occurs when fluid builds up in the thin sac surrounding a testicle, causing the scrotum to swell.
This common condition frequently affects newborns but typically resolves naturally by their first birthday without medical intervention. In older children and adults, hydroceles may develop following scrotal injuries or as a result of other health conditions.
Most hydroceles are:
- Painless
- Non-harmful
- Often require no treatment
Despite their generally benign nature, it’s important to consult a healthcare provider when scrotal swelling appears. This helps rule out other potentially serious conditions that may require medical attention.
Signs and Symptoms
A hydrocele typically causes painless swelling in one or both testicles. In adults, this swelling might create a heavy feeling in the scrotum. Pain may increase as the swelling gets larger.
The size of the swollen area might change throughout the day. It often appears smaller in the morning and expands later in the day.
When Medical Attention Is Needed
If you notice swelling in your or your child’s scrotum, contact a healthcare provider. Getting a proper diagnosis is important because the swelling might have other causes that require treatment.
For instance, a hydrocele could be connected to a weakened area in the abdominal muscles that allows part of the intestine to push into the scrotum (inguinal hernia).
For babies, hydroceles often resolve without treatment within the first year. However, if the condition persists beyond a year or if the swelling worsens, consult your child’s healthcare provider for a follow-up evaluation.
Seek immediate medical care if:
- Sudden, severe pain develops in the scrotum
- Rapid swelling occurs
- Symptoms appear shortly after a scrotal injury
These urgent symptoms might indicate testicular torsion, a condition where blood flow to the testicle is blocked due to twisting. This requires emergency treatment within hours to save the testicle.
Why It Happens
In Newborns
Hydroceles in babies develop during pregnancy. As the baby grows, the testicles move from the abdomen into the scrotum. Each testicle travels with a fluid-filled sac. Usually, these sacs close and the fluid goes away naturally.
In some cases, the fluid remains even though the sac closes properly. Doctors call this a noncommunicating hydrocele. This type typically disappears by the time a child reaches age 1 or 2.
Sometimes the sac stays open, creating what’s known as a communicating hydrocele. The size may change throughout the day, and fluid can move between the scrotum and abdomen. Communicating hydroceles often occur alongside inguinal hernias in babies.
In Adults
For older people, hydroceles typically result from either:
- Physical trauma to the scrotal area
- Inflammation within the scrotum
Inflammation often stems from infections affecting either:
- The testicle itself
- The epididymis (the coiled tube behind each testicle)
These conditions can trigger fluid buildup in the scrotum, leading to hydrocele formation.
Risk Factors
Hydroceles commonly occur at birth, affecting about 5% of male newborns. Babies born more than three weeks early face higher chances of developing this condition.
For hydroceles that develop later in life, several factors increase risk:
- Scrotal injuries or inflammation
- Infections in the genital area
- Sexually transmitted infections
Premature birth significantly raises the likelihood of hydrocele formation compared to full-term babies.
Complications
Hydroceles are typically harmless and rarely impact fertility. However, they may sometimes indicate underlying health concerns that require attention:
- Infection or Tumor: These conditions might reduce sperm production or impair testicular function.
- Inguinal Hernia: A potentially serious condition that can lead to dangerous complications if left untreated.
These associated conditions should be evaluated by a healthcare provider. This is especially important if the hydrocele changes in size, becomes painful, or appears suddenly.
