Hydroceles factsheet
Introduction
Testicles are two glands that make hormones and sperm after puberty. They sit behind the penis, inside a skin pouch called the scrotum.
A hydrocele is a common condition where fluid builds up in the scrotum around the testicles.
During pregnancy, a baby’s testicles develop in the belly. Before birth, the testicles move down into the scrotum through a small tube, which usually closes after birth. If the tube doesn’t close properly, fluid from the belly can leak into the scrotum, causing swelling on one or both sides.
Signs and symptoms
The main sign of a hydrocele is swelling in the scrotum. The size may change during the day.
Hydroceles are usually not painful but can feel uncomfortable for older children.
Go to your nearest emergency department if your child has sudden, severe pain and swelling in the scrotum.
This could be a sign of a hernia or twisted testicle, also known as testicular torsion.
Testicular torsion is a medical emergency and needs treatment as soon as possible.
Diagnosis
Your child’s doctor can diagnose a hydrocele by checking your child’s scrotum and ruling out other causes, like injury.
Treatment
Most hydroceles go away on their own by 15–18 months of age.
If the hydrocele has not gone away by this age, your child may need surgery to drain the fluid.
Hydroceles usually don’t cause serious problems or affect your child’s ability to have children later in life.
Management
Hydrocelectomy
A hydrocelectomy is a procedure to remove the fluid-filled sac.
In a hydrocelectomy:
- your child will be under general anaesthetic and won’t feel any pain
- the surgeon makes a small cut in the scrotum, removes the fluid, and closes the tube with stitches
- stitches under the skin will dissolve on their own.
If recovery goes well, your child can go home the same day. After going home, your child’s doctor will make an appointment to check the scrotum in about a week.
At home:
- let your child rest and limit physical activity
- use ice packs carefully, following the doctor's instructions
- use pain relief, following the doctor's instructions.
There will be a small scar in the crease of the scrotum. It will fade over time, but won’t disappear completely.
When to seek help
See your doctor or go to the nearest emergency department if your child:
- has pain that doesn’t get better with medication
- feels unwell or can’t keep down fluids
- has a fever over 38.5°C
- has bright red blood coming from the scrotum
- has redness, swelling, or warmth in the scrotum.
Go to your nearest emergency department if your child has sudden, severe pain and swelling in the scrotum.
