Pediatric Hydrocele

Pediatric Hydrocele

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Summary

A hydrocele is a fluid-filled sac located around a testicle that causes swelling in a male’s scrotum (pouch of skin that holds the testicles).

Expanded overview

A hydrocele is a fluid-filled sac that develops around a testicle, which causes swelling in the scrotum. In a healthy baby, the testicles descend (drop) from the baby's developing abdomen into the scrotum. A sac accompanies each of the testicles, which allows fluid to surround the testicles. Once the testicles are in place, each sac closes and the fluid is absorbed. A hydrocele forms when some of this fluid remains.

These are common in newborns and typically disappear on their own within the first year of life. It's possible for older boys and adult men to develop a hydrocele, usually due to inflammation or injury within the scrotum.

Causes

A hydrocele can occur due to inflammation (irritation), injury or infection of the scrotum or groin area.

Diagnosis

Hydroceles are generally smooth and do not cause pain in infants. Large or painful hydroceles may need more immediate attention. Because a hydrocele can resemble an inguinal hernia, doctors make a diagnosis based on a physical examination and a complete medical history. Transillumination can differentiate between a hydrocele and a hernia.

There are two types of hydroceles:

  • Communicating: A communicating hydrocele occurs due to an incomplete closure of the tunica vaginalis. Small amounts of abdominal fluid flow in and out of the thin pouch, altering the size of the swelling. It will usually be smaller when a baby is lying flat and more pronounced when he is active.
  • Non-communicating: A non-communicating hydrocele is usually present at birth and most often goes away on its own within a year. Non-communicating hydroceles in older children may be a sign of other problems, such as an infection, tumor or torsion (twisting of the testes).

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