Hydrocele

A hydrocele is a collection of fluid around the testicle beneath its outer covering. In adults, this occurs because the outer covering produces more fluid than it absorbs. Usually this isn’t caused by anything, but sometimes it is a response to something happening to the testicle itself, such as infection or injury.

Hydroceles can also occur in new born boys. When a child is developing in the womb, the testicles develop within the abdomen. The testis descend through the groin into the scrotum early in life. A hydrocele occurs when the passage from the abdomen to the scrotum does not close fully, allowing fluid from the abdomen to collect in the scrotum.

If the hydrocele is small and doesn’t cause any troubling symptoms, it may not require any treatment.

Please note: the information below does not constitute medical advice. If you have any concerns at all, speak to your GP or consultant.

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We would like to thank Mr Peter Grice and Mr Jaskarn Rai, who has helped produce the information in this section for The Urology Foundation.

Learn more about Hydrocele

Hydrocele symptoms

A smooth swelling, often engulfing testicle. This can happen in one or both testicles and swell up to fill the scrotum entirely. It is usually not painful.

 

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Hydrocele diagnosis

The doctor will take your history and examine you.

They may shine a light against the swelling to see if it lights up.

The diagnosis is confirmed with an ultra-sound scan of your testicles. This scan will also look at the testicles themselves, to make sure there is nothing in the testicles that could be causing the problem.

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Hydrocele treatment

  1. Hydroceles can often be left alone. If the testicles themselves are normal, the hydrocele will not damage you in any way. It is important to ask yourself how the hydrocele is affecting your quality of life. Your doctor can help you make this decision.
  1. Surgical repair – there are three common ways of repairing hydroceles, two of which are named after historic surgeons. All have the same impact and involve making a cut in the scrotum and the outer covering around the testicle and draining the fluid.

    The surgeon will usually decide during the operation which is most suitable for you. These are usually performed under a general anaesthetic, meaning you would be asleep for the operation. Alternatively, a spinal anaesthetic is sometimes considered, meaning you are awake but cannot feel anything below your waist.
  1. Jaboulay procedure – the outer covering of the testicle is cut and folded back on itself
  2. Lord’s procedure – the outer covering of the testicle is bunched up and sutured together
  3. Excision – the outer covering of the testicle is completely removed

After the surgery, the structures and cord of the testicle will feel bulkier than the normal side but will be dramatically less swollen. You may encounter some minor swelling over the days following the surgery, but any discomfort can be dealt with through over-the-counter painkillers like paracetamol.

 

  1. Aspiration and sclerotherapy – This where the surgeon inserts a needle into the hydrocele and removes the fluid before injecting a liquid to create a scarring process. This reduces the chance of the hydrocele coming back in the future. This can be done while you are awake. The drawback is that the hydrocele can often come back and there is still a risk of infection, as you may get with surgery. The scar process is also painful.

 

You must never attempt to put a needle into the hydrocele yourself. This is because you can damage your testicle or contaminate the fluid. The hydrocele will most likely return, and you could cause an infection that would turn a simple medical problem into a complicated one

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