What is it?
A hydrocele is a fluid-filled sac that surrounds a testicle, causing swelling in the scrotum. In babies and young boys, hydroceles are common and usually harmless. They often disappear on their own within the first year of life, but sometimes surgery is needed if the swelling persists.
Types of Hydroceles:
- Communicating hydrocele: Caused by an open connection between the abdomen and scrotum, allowing fluid to move in and out. Swelling may change in size during the day.
- Non-communicating hydrocele: Fluid is trapped around the testicle. The swelling is usually constant in size.
Key Symptoms:
- Soft, painless swelling in the scrotum
- In communicating hydroceles, swelling may be larger in the evening or after activity
- Usually not tender and does not cause pain
- Important: swelling should always be checked to rule out hernia or other conditions
Causes & Risk Factors:
- Incomplete closure of the processus vaginalis (the tunnel through which the testicle descends before birth)
- More common in premature babies
- May also occur after minor trauma or infection in older children
Diagnosis:
- Physical examination by a doctor
- Scrotal ultrasound may be used if diagnosis is uncertain or to rule out other causes of swelling
Treatment Options:
- Observation: Many hydroceles resolve on their own in the first 12–18 months of life.
- Surgery (hydrocelectomy): Recommended if the hydrocele persists beyond age 1–2 years, is very large, or is associated with a hernia. This is usually a day-case operation, and recovery is quick.
Why seek help?
Although paediatric hydroceles are usually harmless, persistent or enlarging scrotal swelling should always be evaluated. This ensures that other conditions (such as hernia or testicular problems) are not missed, and that treatment can be provided if needed.