Definition

A hydrocele is a build-up of fluid in the membrane that surrounds the testicle.

Types of hydrocele include:

• Communicating—present at birth, generally found in infants and young children
• Noncommunicating—acquired, occurs at any age, mostly in adults

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Causes

A communicating hydrocele is more common in infants and children. It occurs during fetal development. Testicles develop in the abdomen. They eventually move into the scrotum through a small channel. This channel should close after the testicles pass through it. When the channel does not close, fluid can pass from the abdomen into the membrane covering the testicle.

A noncommunicating hydrocele is more common in adults. It may be caused by an injury or infection that causes fluid build-up. It can also be a complication of surgery. In some cases, the cause is unknown.

Risk Factors

Factors that may increase the chances of a hydrocele:

• Premature birth
• Injuries to the testicles or scrotum
• Infections, including those that are sexually transmitted

Symptoms

A hydrocele may not always cause symptoms. When they do appear, a hydrocele may cause:

• Swelling of the scrotum
• Feeling of heaviness or soreness in the scrotum
• Swelling with activity or standing—especially with a communicating hydrocele

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A hydrocele is usually diagnosed by physical exam. The doctor may want to do tests to confirm a cause or rule out other conditions.

Tests may include:

• Transillumination—A bright light is shined through the swollen part of the testicle.
• Ultrasound —May be done if the diagnosis is unclear or to rule out other causes such as a testicular mass.

Treatment

Treatment options include:

Prevention

Some hydroceles cannot be prevented. However avoiding testicular trauma, such as by wearing protective gear during contact sports, may reduce the chances of developing some types of hydroceles.