Hydrocele testis is a medical condition in which fluid fills the tunica vaginalis, a sac that surrounds a testicle, and causes swelling in the scrotum. A hydrocele, which is the fluid-filled sac, is commonly found in newborns and can occur in older children or adults as well. In newborns, it occurs when the sac around the testicles does not close all the way during the baby’s development in the womb. In older children and adults, it can occur for a variety of reasons, such as when there is an inflammation, infection or injury in the scrotum. Hydrocele testis is not painful and usually goes away on its own.
When in the womb, a baby’s testicles descend to his scrotum from his abdomen. The sac around the testicles usually closes, and any fluid that remains eventually gets absorbed, but sometimes the sac does not close completely. When it does not, fluid is able to flow in and out, resulting in a hydrocele. A sac that does not close all the way is called a communicating hydrocele; since fluid flows in and out, swelling of different sizes can occur. When the unclosed sac is present at birth, but goes away on its own, the condition is known as a non-communicating hydrocele.
The primary symptom associated with hydrocele testis is swelling in one or both testicles. The hydrocele is usually painless, smooth, and might change in size. For adults, the swelling might cause discomfort due to a feeling of heaviness in the scrotum. Though hydrocele testis is generally harmless, it can sometimes warrant medical attention, especially if the swelling does not go away on its own.
To diagnose hydrocele testis, a doctor will usually perform a physical exam, and he might use an ultrasound to confirm his diagnosis as well. During the physical exam, he will be able to ascertain what is causing the condition to occur. In addition, he will be able to tell if the swelling is not a hydrocele, but in fact an inguinal hernia, which is a medical condition in which a part of the small intestine protrudes through the lower abdominal wall.
Hydrocele testis does not usually require treatment. In newborns, the sac should close on its own within a year. For adults, the hydrocele should resolve itself as well. If the condition causes too much discomfort, grows too large and causes disfigurement, or does not heal on its own, treatment options include needle aspiration or surgery.