Hydrocele

Hydroceles usually don’t cause any symptoms or any pain. The only sign of hydrocele is a swollen scrotum. In adults, there may be a feeling of heaviness in the scrotum. In some cases, it can be uncomfortable as well. People may find swelling more painful in the morning than in the evening. 

The cause of hydrocele depends on the person’ age. In infants, it can occur during pregnancy. The testicles develop near the kidneys in the abdomen of a male fetus. At the end of the full-term pregnancy, they move down to their usual position in the scrotum through a muscle lining (inguinal ring), forming a sac. 

Once the testicles are moved into the position, the inguinal ring closes. If the ring stays open, fluid can pass from the belly to the scrotum through this canal. However, the inguinal ring may be reopened in adults due to possible causes like injury, inflammation or injection. This allows the creation of hydrocele. 

Hydrocele can be classified into two different types, including: 

1. Communicating hydrocele: This type of hydrocele occurs due to the failure of the processus vaginalis, which is a thin membrane that extends through the inguinal canal into the scrotum. The sac surrounding the testicle does not seal, allowing fluid to flow in and out. Communicating hydrocele can also lead to hernias. 
2. Non-communicating hydrocele: This is another type of hydrocele. It occurs when the inguinal canal closes, but there is extra fluid around the testicles in the scrotum. The body generally absorbs the remaining fluid within a period.

Your doctor will diagnose a hydrocele through various tests and observations, including: 

• Physical Exam: During the physical exam, your doctor may check for tenderness in the scrotum. He may also shine a light in the scrotum to check there is an accumulation of fluid. 
  
  
• Tests: Your doctor may also ask to get some blood or urine tests done to check for any infections. 
  
  
• Ultrasound: This can be done to check for hernias, tumors or any other cause of scrotal swelling. 

Hydrocele goes away on its own in most cases. In infants, it will probably go away in about one year. In adults, hydrocele generally goes away within six months. That said, in some cases, you may need some treatment if it is a communicating hydrocele or if it causes any discomfort. The treatments are as follows: 

• Surgery: A hydrocelectomy surgery is required to remove a hydrocele, which is performed under anesthesia. During the procedure, the surgeon makes a small incision in the abdomen or scrotum, depending upon the location of the hydrocele. It is then removed surgically.  
  
  
• Needle aspiration: Another option for removing hydrocele is needle aspiration. During this procedure, the surgeon drains the fluid using a needle. In some cases, a drug may also be injected into the sac to prevent it from filling it again.

In most cases, hydrocele does not pose any serious risk and affect fertility. However, in rare cases, hydrocele can result in an inguinal hernia, which can cause dangerous complications. This happens when a loop of the intestine sticks out through a weak spot in the abdominal wall and gets trapped. 

The long-term outlook for hydrocele is generally good. In infants and adults, simple hydroceles often go away without surgery. However, in some adults, the hydrocele can reoccur even after surgery. 

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