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Definition

Hydrocele is a condition wherein watery fluid accumulates around the testicles. This leads to the swelling of the scrotum. While there is no pain associated with it, the person may experience mild discomfort besides an ungainly body image. Hydroceles are most common in newborn male infants but can also occur later in life at any age.

Hydrocele in children

Some babies are born with a hydrocele. Hydroceles are very common in babies. When babies develop in the womb (uterus), the testicles (testes) move from the abdomen to the scrotum. Sometimes the passage which allows this to happen does not close completely. This may then lead to a hydrocele developing.Hydroceles can sometimes be associated with a hernia. Premature babies have a higher risk to develop Hydrocele. In older children a hydrocele may have other causes such as injury, torsion of the testis or nephrotic syndrome.

Adult Hydrocele

If Hydrocele shows up in adult life, it is typically a result of groin related surgery or a physical injury. Sometimes, inflammation or infection (epididymitis) in the testicles can also be the cause. Older males have a higher propensity . Hydrocele may also surface along with testicle cancer in rare cases. There are two types of Hydroceles – communicating hydroceles have the fluid flow in and out around the testicles while non communicating hydroceles occur when the body does not absorb the fluid away from the sac surrounding the testicles.

Symptoms

Typically, there is no pain associated with Hydroceles. The only prominent symptom is a swelling around the scrotum. Adults may experience heaviness around the area and the swelling may wax and wane during the day. Other symptoms may include pain or redness.

Risk Factors

There is no known medical cause for most hydroceles. However, you should seek urgent medical treatment if testicular torsion takes place (twisting of testes) – this happens due to an accident or physical injury. The danger associated with this condition is that it can lead to blockage of blood supply to testes. It would typically happen suddenly with a sharp shooting pain.

Diagnosis

Physical examination by the doctor is the usual method. The doctor may also feel the testes for tenderness. If there is hydrocele, the doctor will not be able to feel the testicles through the fluid filled testicular sac. Another method is by shining a light behind the testicles. If there is fluid present, there will be light transmission and the scrotum will glow with diffused light. However, if this swelling is due to cancer, then the light will not pass through.

Treatment

Typically hydroceles go away on their own. In infants, they may persist up to a year but go away eventually. An operation is usually only advised if the hydrocele persists after 12-24 months of age.

In adults, they typically go away in about six months. Sometime they tend to stay longer in elderly men. In case there is no let up on the swelling, then aspiration or surgery is the preferred method.

In the aspiration method, fluid is drained out from the hydrocele using a fine needle. However, chances of swelling coming back are quite high.

Surgery is needed if the hydrocele is a communicating one as it can lead to hernia. Surgery is performed under anesthesia and the patient is discharged within a couple of hours. Typically this involves a small incision for the surgical removal of hydrocele. Large size dressing is applied afterwards along with support for scrotum and the patient may need fluid drainage tubes for about a week. There are no major risks associated with the surgery.

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