Hydrocele

A hydrocele, also known colloquially as a hydrocele, is a collection of clear fluid between the testicular membranes. It occurs either congenitally (in infants) or acquired (in adults) and can be unilateral or bilateral.

Congenital hydrocele

In infants, it usually develops due to an open connection between the abdomen and the scrotum, which normally closes shortly after birth.

Acquired hydrocele often occurs in connection with

• Injuries to the testicle or groin area
• Inflammations (e.g., epididymitis)
• Tumors in the testicle
• After surgeries (e.g., varicocele surgery, inguinal hernia)

• Swelling of the scrotum, usually painless
• Feeling of tension or a pulling sensation in the scrotum
• May increase in size over the course of the day
• Usually no redness or warmth

Diagnosis is made by palpation and ultrasound. The swelling is typically transilluminated with a flashlight (transillumination). It is important to differentiate it from more serious causes such as testicular tumors or inguinal hernias.

Not every hydrocele requires immediate treatment. The decision depends on the size, symptoms, and cause:

Wait and see: For small, asymptomatic hydroceles, observation is often sufficient.

Surgery: If the hydrocele becomes too large or is becoming increasingly large, the fluid is surgically removed (hydrocelectomy). This involves removing or folding over the inner lining of the testicle to prevent new fluid from forming.