What is a Hydrocele?
A hydrocele is a fluid-filled sac that forms around the testicle, creating a painless swelling in the scrotum that often looks like a water balloon surrounding the testicle. 1
Understanding the Basics
- The fluid collects between two thin layers of tissue (called the tunica vaginalis) that normally surround each testicle like a protective envelope 1
- Think of it like a water balloon forming around the testicle - the testicle itself is fine, but fluid accumulates in the space around it 2
- The swelling is typically painless and feels soft or squishy when touched, and a flashlight held up to it will glow through (doctors call this "transillumination") 3
Why It Happens
In Babies and Young Children
- During development before birth, a tunnel forms as the testicle descends from the abdomen into the scrotum, bringing a lining of tissue with it 4
- Normally this tunnel closes off completely, but sometimes it doesn't seal properly, allowing fluid to seep down and collect around the testicle 4
- Most infant hydroceles resolve on their own by 12-18 months of age as the tunnel naturally closes 4, 3
In Older Children and Adults
- The fluid-producing and fluid-absorbing balance gets disrupted - the tissue lining produces more fluid than it can reabsorb 1, 2
- It can develop after injury, infection, or surgery in the scrotal area, or sometimes for no clear reason at all 2, 5
What You'll Notice
- A painless swelling in the scrotum that may be on one or both sides 3
- The swelling may fluctuate in size throughout the day if there's still a connection to the abdomen (more common in babies) 2
- No pain or discomfort in most cases, though very large ones can feel heavy 5
When Treatment is Needed
- In babies under 12-18 months, just watching and waiting is recommended since most resolve naturally 6
- Surgery is considered if the hydrocele persists beyond 18-24 months, continues to grow, or causes discomfort 4, 7
- The procedure involves draining the fluid and closing off the sac to prevent it from refilling 1