What is a hydrocele?
A collection of fluid in the scrotum, around the testis. When a light shines into the fluid it glows (called ‘transillumination’).
Why does it form?
A small tube, called the processus, connects the abdominal cavity to a sac called the tunica, which is attached to the testis. The processus normally closes and blocks off soon after birth, but sometimes it stays open. This allows the normal fluid from the abdominal cavity to fill up the sac next to the testis making the hydrocele.
How common are hydroceles?
About 10% of babies have a hydrocele (sometimes on both sides).
However, 9 out of 10 resolve by themselves within the first year or so.
Are they dangerous?
Simple hydroceles are not dangerous, do not cause pain and do not damage the testis.
Occasionally a problem with the testis may either mimic a hydrocele or cause a secondary hydrocele. If there is any concern that there may be something wrong with the testis itself, urgent medical advice should be sought. Pain, redness or inflammation of the scrotum would be reasons to see a doctor urgently.
What is the treatment?
No treatment unless the hydrocele is still present at 2 years of age. Most will have resolved spontaneously by this age.
After age 2, surgical correction is recommended.
How is surgery performed?
Under a general anaesthetic (asleep) in the operating room.
The operation is sometimes called ‘herniotomy’ because it is the same procedure as for a hernia.
An incision is made in a skin crease in the part between the lower abdomen and the groin, called the ‘inguinal’ region.
The tubes going to and from the testis (blood vessels and vas) are carefully separated from the processus. The processus is tied off and divided. The fluid is drained away.
What are some of the risks?
- Infection
- Bruising or bleeding
- Injury to the testicle vessels or vas
- Recurrence
(all uncommon)
