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Hydrocele

What is hydrocele?

Hydrocele is a build-up of fluid in the sac inside the scrotum. Before birth, a boy's testicles move down from his belly (abdomen) into his scrotum. They travel inside a fluid-filled sac (called the processus vaginalis and pronounced pross-ESS-uss vaj-in-AIL-iss). Normally the opening between the abdomen and the sac closes. Then the boy's body absorbs the fluid.

Hydrocele occurs for these reasons:

  • The opening doesn't close, and fluid keeps draining from the abdomen into the sac. This is called a communicating hydrocele and is treated like a hernia with surgery. The main symptom is that the parents notice the scrotum changes size over the course of the day as fluid either fills the sac or drains back into the abdomen.
  • The opening closes, but the boy's body doesn't absorb the fluid before he's born. This is called a simple hydrocele and will usually go away on its own by the time the child is one year old. The main symptom is that the scrotum stays the same size over the course of a day and very slowly gets smaller over time.

Who gets hydrocele?

Hydrocele is common. About 1 in 10 boys has a simple hydrocele when he's born. In some boys a communicating hydrocele becomes apparent later, even though the opening leading into the sac was present at birth (congenital).

What are the symptoms?

If your son has a communicating hydrocele, you may notice swelling in the scrotum that comes and goes. You may see it enlarge when your child is active or crying, and decrease when he's relaxed or resting. A simple hydrocele will stay the same size or slowly get smaller with time. Neither type of hydrocele causes pain or any other symptoms in most cases.

How do you diagnose hydrocele?

The doctor will carefully examine your child's belly area and groin, looking and feeling for hydrocele. Sometimes doctors shine a light through the scrotum to tell whether the sac is filled only with fluid or also with other tissue, as in a hernia.

What is your experience with hydrocele at Children's?

We treat many children with hydrocele at Children's. Some of these children are seen and cared for by doctors in our General & Thoracic Surgery Department and others are treated by our Urology Department. Both departments can take care of children with this condition. The General & Thoracic Surgery Department takes care of several hundred chidren each year with hernias and hydroceles.

When you come to Children's, you have a team of people to care for your child before, during and after surgery. Along with your child's surgeon, you are connected with nurses, child life specialists and others. We work together to meet all of your child's health needs and help your family through this experience.

Since 1907, Children's has been treating children only. Our team members are trained in their fields and also in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age. Our expertise in pediatrics truly makes a difference for our patients and families.

How do you treat hydrocele?

If your son has a simple hydrocele, his doctor will probably suggest waiting to see if hydrocele goes away on its own. In most children it does. If your son's hydrocele remains by the time he's 1 year old, he may need surgery to correct it. This surgery is called hydrocelectomy (pronounced hi-druh-see-LEK-tuh-mee). A communicating hydrocele should be treated like a hernia; your son will need surgery to repair it.

Your child will have general anesthesia. This means we will give your child medicine to make them sleep without pain during the surgery. The surgery is done through a small cut, or incision, in the crease between the leg and the lower abdomen. The surgeon will drain the fluid, remove the sac and then close the opening between the lower belly and groin. Finally, the surgeon will close the incision. The surgery takes about 30 minutes. Your child will be in the recovery room for another hour. In most cases, you can take your child home the same day he has surgery to repair a hydrocele.

We will give your child pain medicine to make him comfortable. You'll need to keep the incision clean and dry until it heals. The surgery team will teach you how to care for the incision and tell you whether you need to limit your child's activity for a while.

About two to three weeks after surgery, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure the incision is healing and your child is recovering well.

Resources

Read more about what to expect when your child visits a clinic at Children's, has surgery here or needs to stay in the hospital. You can get practical details about topics like what to do and bring the day of surgery and who will be on your child's care team. You can also take a virtual tour of our surgery rooms and other parts of the hospital.

To learn more about this condition, you may want to visit our resource list.