A hydrocele is a common medical condition defined by the accumulation of watery fluid within the scrotum, specifically around one or both testicles, causing noticeable swelling. This fluid-filled sac is frequently observed in male infants, though it can also develop later in life in adolescents and adults. While the swelling can cause alarm, a hydrocele is generally a benign finding that requires medical distinction from other conditions.
Understanding What a Hydrocele Is
The cause of a hydrocele relates to the developmental anatomy of the testicles, which descend from the abdomen into the scrotum before birth. They are accompanied by a pouch of the abdominal lining called the processus vaginalis, which is supposed to seal off completely after descent.
A failure of this closure results in a communicating hydrocele, the most common type seen in newborns and young children. This open connection allows peritoneal fluid from the abdomen to flow into the scrotum. The swelling may increase and decrease in size throughout the day depending on body position or activity.
In contrast, a non-communicating hydrocele occurs when the processus vaginalis has closed, but fluid remains trapped or accumulates due to an imbalance between fluid production and absorption. This acquired type is more common in adults, often developing spontaneously or as a reaction to local inflammation, trauma, or infection.
Why Hydroceles Are Generally Not Considered Dangerous
The majority of hydroceles are not associated with long-term health risks. They are usually painless, with the primary symptom being the feeling of heaviness or discomfort due to the size of the swelling.
For infants, congenital hydroceles often resolve completely on their own without intervention. The fluid is naturally reabsorbed by the body as the processus vaginalis closes fully, a process that happens spontaneously in most cases by the child’s first birthday.
A simple hydrocele does not damage the testicle or affect testicular function in children or adults. The fluid collection itself is sterile and does not pose a systemic threat to health. Treatment is generally only considered when the size causes significant physical discomfort or compromises the integrity of the scrotal skin.
Indicators That Require Immediate Medical Evaluation
Although most hydroceles are harmless, any scrotal swelling must be medically evaluated to rule out conditions that pose a serious threat. A healthcare provider uses diagnostic tools, such as transillumination or ultrasound, to confirm the fluid-filled nature of the swelling and ensure it is not a solid mass.
Immediate medical attention is necessary if the swelling is accompanied by a sudden onset of severe pain. This symptom can indicate testicular torsion, a twisting of the spermatic cord that cuts off blood supply to the testicle. Emergency surgery is required to prevent tissue death.
Other warning signs that warrant a prompt visit include redness, warmth, or fever, which could signal an infection like epididymitis. The swelling may also be a symptom of a more serious underlying issue, such as an inguinal hernia or, in rare cases, a testicular tumor.
If a hydrocele persists past one year of age in a child, or if it causes significant discomfort in an adult, a hydrocelectomy may be recommended. This surgical option removes the fluid sac and closes the communication to prevent recurrence.