A hydrocele is an accumulation of fluid between a testicle and the surrounding testicular sheath. The scrotum swells as a result. Even if a hydrocele does not usually cause any pain, it should always be examined and treated if necessary.
Below you will find further information and selected specialists for hydrocele.
A hydrocele can be congenital or only occur in advanced childhood or adulthood.
In congenital hydrocele (also known as primary hydrocele), the peritoneum over the scrotum does not close properly. This allows fluid from the abdominal cavity to enter the testicles.
An acquired hydrocele (also known as a secondary hydrocele) can have various causes, such as
However, it is not always possible to find a cause for an acquired hydrocele. Sometimes it occurs for no apparent reason.
The accumulation of fluid in the scrotum causes it to swell on the affected side (or both sides). This enlargement can be inconspicuous or very large, depending on the amount of fluid accumulated. The scrotum often feels firm and elastic.
Smaller hernias usually do not cause any further symptoms.
If the accumulation of fluid is large, however, it can lead to
may occur.
In the case of a congenital hydrocele, the swelling is usually worse when standing than when lying down. In infants, the swelling increases when they cry.
With a hydrocele, water accumulates in the testicles, which leads to significant swelling © Artemida-psy | AdobeStock
In rare cases, a serious illness can be the trigger for the formation of a hydrocele. A urologist should therefore always examine the swelling.
The diagnosis is made by palpation of the testicles and an ultrasound examination.
In isolated cases, magnetic resonance imaging(MRI) is also necessary. In most cases, however, a hydrocele can already be diagnosed with an ultrasound examination. It is also possible to detect or exclude a testicular tumor or a hematoma.
If the hydrocele in a newborn is not too large, it usually does not need to be treated immediately. The development of the hydrocele is monitored for several months, sometimes even up to the second birthday.
In most cases, the connection between the abdominal cavity and the scrotum closes on its own during this time . The body then removes the accumulation of fluid itself.
If this does not happen, the opening is surgically closed in the second or third year of life. If the symptoms are severe, an earlier operation may be advisable.
If the diagnosis identifies a cause for the hydrocele, this underlying disease must be treated. In many cases, the hydrocele will then subside.
In the case of a small hydrocele that does not cause any symptoms, treatment is not necessary. In many cases, however, surgery is necessary. It is performed from the scrotum: The operating doctor opens the testicular sheaths and removes the fluid. The testicular sheaths are then also removed or folded back, but this has no disadvantages.
After the operation, the patient usually remains in hospital for a few days. Afterwards, the testicles must be kept cool and elevated to prevent swelling. Depending on the individual situation, outpatient surgery is often possible.
Surgery is particularly recommended if
Older treatment methods, such as puncturing or sclerotherapy, are rarely performed today. They have too many disadvantages, including
Without treatment, a severe hydrocele can lead to serious complications:
However, these complications are rare. In many cases, the primary hydrocele in particular resolves on its own. The prognosis is also good after an operation.
Swelling of the testicles is common after an operation, but usually disappears again soon. The scrotum should be cooled and elevated to provide support. It may also be necessary to wear tight underpants to keep the swelling to a minimum.
Other possible complications following surgical treatment are secondary bleeding and infections. However, these rarely occur.
After surgery, the risk of recurrence is low and in most cases the problem disappears permanently.
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