The testicles develop near kidneys in the abdomen and descend from that location to their normal position in the scrotum towards the end of pregnancy. In order for the testicles to leave the abdomen, a muscle ring in the groin on each side opens and allows the testicles to drop down to the scrotum. As the testicle descends, the lining of the abdomen also drops to line the scrotum. This channel closes in most boys. If that channel remains open, or reopens, a small amount of fluid can go from the abdomen to the scrotum through this passage. This results in hydrocele. If the channel remains opens or reopens widely, then a portion of the intestine can pass down the channel towards the scrotum. This results in an inguinal hernia.
Hydroceles can also develop due to inflammation or injury within the scrotum. These sometimes resolve over a few months but many remain and require medical attention. Hydroceles can also happen after injury and swelling of the scrotum and can often resolve on their own.
Hydrocele Signs & Symptoms
A hydrocele usually remains painless but may cause discomfort due to the increased size of the scrotum. Sometimes a man may feel a small fluid filled sac when performing a testicular self-examination and is prompted to contact his primary care physician or urologist. Most patients do not experience any symptoms
Your provider will conduct a physical exam check for tenderness and the presence of the fluid filled sac. The definite way to confirm the presence of a hydrocele is by a non-invasive scrotal ultrasound.
Hydroceles require surgical repair if they cause symptoms, such as growing large or changing size significantly during the day. If the hydrocele is uncomplicated an incision is made in the scrotum and the hydrocele is surgically removed and the incision is closed.