What is Hydrocele?

Testes are located within the scrotum and are surrounded with a minimal amount of fluid. In normal conditions, this fluid is produced and continuously reabsorbed so that its amount remains stable. In some cases, however, the fluid increases inducing dilation (enlargement) of the scrotum. This fluid collection around the testis is called Hydrocele and usually occurs in only one testis. Hydrocele is very common in babies, and particularly during the first year of their life. However, it may also occur in older boys, even in adult males. 

What are the symptoms of Hydrocele?

In most cases, the only indication of hydrocele is painless testicular enlargement (in one testis or both testes). If it progresses in adults, it induces a feeling of discomfort and dragging due to high testicular weight. In any case, in the event of any scrotal dilation, you should promptly visit your doctor.

What are the causes of Hydrocele?

In little boys, hydrocele may be formed during intrauterine life. Testes are initially within the abdomen and gradually descend to the scrotum, along with a surrounding sac that contains some amount of fluid. At some point, the opening of the sac from the abdominal side normally closes down and the fluid remains in the space between the scrotum and testis.In adults, hydrocele may develop as some testicular inflammation or injury, or as a postoperative complication after varicocele surgery.

What complications may arise from Hydrocele?

In general, hydrocele is not dangerous; as long as it does not progress severely, it does not affect fertility. However, it always has to be investigated whether its etiology involves any severe disease, such as testicular inflammation or cancer.  

How is Hydrocele diagnosed?

The patient's medical history and clinical examination are usually sufficient  for the physician to set the hydrocele diagnosis. During physical examination, the Urologist may shine a small torch through the scrotum, to ensure that there is accumulated fluid inside and to exclude the case of any other disease. If necessary, testicular ultrasound screening will be performed to confirm the diagnosis and rule out any other conditions that might potentially cause testicular dilation. 

What is the treatment of Hydrocele?

In neonates, simple monitoring is recommended, for hydrocele usually subsides on its own within the first year of life.  Also in adults, hydrocele is likely to disappear within the first 6 months. However, when it has progressed inducing high discomfort, hydrocele has to be treated surgically. The patient recovers fast and is discharged from hospital the first postoperative day. Yet, the scrotum has to be kept elevated towards the testes for a period of about 2 weeks. This is achieved with the use of jockstrap (undergament supporter designed for supporting male genitalia). In high postoperative risk patients (e.g. with severe cardiorespiratory problems or who are on anticoagulant therapy that cannot be discontinued), alternatively the fluid can be removed with needle aspiration (a procedure performed  at the physician's office). The recurrence rate of hydrocele is high.