Hydrocele

Medically Reviewed by Amita Shroff, MD on September 19, 2022
Written by David Steen Martin
3 min read

A hydrocele is a swelling in the scrotum, the thin sac that holds the testicles. It happens when too much fluid builds up inside. The condition is most common in newborns, though it can happen to anyone with a scrotum.

It may sound or look serious, even painful, but it won’t hurt your baby. It might go away on its own, though you should still see the doctor about it.

A hydrocele can start before your baby is born. The testicles grow inside their belly and then move down into their scrotum through a short tunnel. A sac of fluid goes with each testicle. Usually, the tunnel and the sac seal off before birth, and the baby’s body absorbs the fluid inside. When this process doesn’t go as it should, they can get a hydrocele.

There are two types of hydrocele: 

  • A noncommunicating hydrocele happens when the sac closes like normal, but the boy’s body doesn’t absorb the fluid inside it.
  • A communicating hydrocele happens when the sac doesn’t seal. With this type, their scrotum may swell more over time.

Babies born prematurely are more likely to have a hydrocele.

A hydrocele doesn’t hurt. The only symptom you’ll notice is that one or both of the baby’s testicles look swollen. Even if they are not in pain, you should see the pediatrician to make sure they don’t have other health problems that are causing the swelling, such as an infection, a tumor, or a hernia.

The swelling from a noncommunicating hydrocele doesn’t have changes in size. A communicating hydrocele can get bigger during the day, and if you gently squeeze it, the fluid will move out of the scrotum and into their belly.

When you take your baby to the doctor, they’ll do a physical exam. They’ll check the scrotum for fluid and tenderness, and shine a light through it to see if there’s fluid around their testicle.

Your doctor will also check to make sure your baby doesn’t have a hernia.

Your baby may also have a blood test and an ultrasound to make sure nothing else is causing the swelling.

A hydrocele usually goes away on its own before a boy’s first birthday. If it doesn’t, or if it gets bigger, their doctor will refer them to a specialist called a urologist. 

If your son has a communicating hydrocele, the pediatrician will usually recommend surgery without waiting for it to go away.

The doctor can remove a hydrocele in a brief operation called a hydrocelectomy.

Your baby will get a local numbing agent or be put to sleep under anesthesia.Then, a surgeon makes a cut in their scrotum or lower belly. The surgeon then drains the fluid and sews the sac closed. Once it’s finished, your son can go home the same day.

In the days after surgery, you’ll need to keep the area clean and dry. The doctor and team will show you how to care for your baby as they heal.

After a few days, you may need to take them back to the doctor to make sure they are healing well.

 

Most of the time, a hydrocele isn't very serious and doesn’t usually affect fertility later on in life. But sometimes, the presence of a hydrocele might mean there’s a more serious problem with the testes and potential complications. These include:

  • Infection or tumor. These could reduce sperm production or function.
  • Trauma
  • Inguinal hernia. This happens when a loop of intestine sticks out through a weak spot in the abdominal wall, and gets trapped. This can cause dangerous complications.