A hydrocele is a swelling of the sac (scrotum) that contains a testicle, caused by an accumulation of excess fluid in the surrounding membrane. It can occur on one or both sides. Hydroceles may be present at birth (congenital hydrocele), are most common in infants, but can occur at any age.

Symptoms

Visible swelling of the scrotum, heaviness, softness to touch, not normally painful, but may be uncomfortably large.

Causes

In many cases there is no apparent cause, they are sometimes linked to infection, inflammation or minor injury. They may also occur because of previous operation on the testicles or groin. In infants they can occur in association with an inguinal hernia in the groin. Very rarely, hydroceles occur because of testicular cancer.

Diagnosis

GP will identify a hydrocele by shining a light through the scrotum to illuminate the fluid causing the swelling. An ultrasound scan may be advised to exclude other testicular disorders.

Treatment

Treatment largely depends on age and level of discomfort caused by the hydrocele, and it is common to be referred to a urinary system specialist (urologist) for a decision. In infants hydroceles may subside by age 6 months without any treatment.

In adults they may cause no problems or risks so can be left alone. Antibiotics may be given if the hydrocele appears to be caused by an infection. A minor operation may be performed in hospital to empty the scrotum membrane of excess fluid (aspiration, also known as a hydrocelectomy). 

Suspected testicular cancer requires further tests and specialist advice.

Infants with a hernia also present have an operation to repair the hernia, and at the same time close the passage through which the testicles descend, which may have been allowing fluid to pass into the hydrocele.