Kidney, Reproductive and Urinary Conditions

Hydrocele

What is hydrocele?

Hydrocele (pronounced HI-druh-seal) is a buildup of fluid in the sac inside a boy’s scrotum.

Before birth, a boy’s testicles move from his belly (abdomen) into his scrotum. A small, thin sac that holds the intestines in place moves with the testicles into the scrotum. Normally, after the testicles move down, the sac inside the scrotum closes, and the boy’s body absorbs any extra fluid trapped inside the sac. If the sac does not close, or if it closes but extra fluid stays trapped inside, this is called a hydrocele.

  • There are 2 types of hydrocele:

    • Simple hydrocele. The sac in the scrotum closes, but the boy’s body does not absorb the fluid before he is born. This type of hydrocele usually goes away on its own by the time a boy is a year old because his body eventually absorbs the fluid. Hydrocele is common in boys. About 1 in 10 boys in the United States is born with a simple hydrocele.
    • Communicating hydrocele. The sac that moves from the belly into the scrotum does not close all the way and a very small opening remains. Fluid keeps draining from the belly into the scrotum. This type of hydrocele is similar to a hernia. But in a hernia, the opening to the sac is large, and intestine can enter the sac along with fluid. Like a hernia, a communicating hydrocele requires surgery.

Hydrocele at Seattle Children’s

Doctors in our Pediatric General and Thoracic Surgery and Urology programs have a great deal of experience and expertise in treating hydrocele. Each year, we take care of several hundred boys who have hernias and hydroceles.

  • We do more minimally invasive procedures on children for a broader range of conditions than any hospital in the region. After this type of surgery, your child is likely to heal faster with less pain and go home from the hospital sooner.

    Children react to illness, injury, pain and medication differently than adults. They require – and deserve – care designed specifically for them. Our pediatric experts understand how treatments today affect growing bodies in the future and are specially trained to meet the needs of children and teens.

    We provide the right care, at the right time. We are committed to avoiding unnecessary diagnostic tests, radiation and surgery. Radiation doses at Seattle Children’s are consistently lower than the guidelines recommended by the American College of Radiology.

    Seattle Children’s is 1 of just 5 hospitals nationwide whose commitment to preventing and relieving kids’ pain has been recognized by ChildKind International.

  • When it comes to your child’s health, experience matters. Our surgical teams have the skills to do it right the first time, to handle the unexpected and to care for children with the rarest conditions.

    More cases mean greater surgical expertise and a sharper ability to determine if surgery is even necessary. All that adds up to better outcomes.

  • When you come to Seattle Children’s, you have a team of people to care for your child before, during and after surgery. Along with your child’s surgeon, you are connected with nurses, dietitians, child life specialists and others. We work together to meet all of your child’s health needs and help your family through this experience.

    We work with children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Learn about our services for patients and families.

Symptoms of Hydrocele

Symptoms may depend on the type of hydrocele. If your child has a communicating hydrocele, you may notice his scrotum changes size over the course of the day. This is because fluid is either filling the sac or draining back into his belly.

  • Swelling in the scrotum may be on 1 or both sides.
  • Swelling may increase when your baby is active or crying.
  • Swelling may decrease when he’s relaxed or resting.
  • In most cases, communicating hydroceles do not cause pain.
Symptoms of a simple hydrocele are:

  • Swelling stays the same over the course of the day.
  • Swelling very slowly gets smaller over time.
  • Simple hydroceles usually disappear before a boy’s first birthday.

Diagnosing Hydrocele

Your baby’s doctor will examine your child’s belly area and groin, looking and feeling for a swollen scrotum that is not painful. Sometimes the doctor is not able to feel a boy’s testicles because there is so much fluid in the scrotum. The doctor may be able to make the size of the sac bigger or smaller by pressing on the boy’s belly or scrotum.

Sometimes doctors shine a light through the swollen scrotum. If your child has a hydrocele, the scrotum will look like it is full of clear fluid. If the doctor can see other tissue, the baby might have a hernia.

In some unusual cases, the doctor might ask to have an ultrasound exam of your child to make sure of the diagnosis.

Treating Hydrocele

Neither type of hydrocele is dangerous. Communicating hydroceles are usually fixed with surgery because they can lead to hernias. Doctors usually recommend surgery at the time of diagnosis.

Simple hydroceles usually go away on their own. Doctors consider surgery for simple hydroceles only if the hydrocele is still present when the child reaches his first birthday.

Surgery for Hydrocele

Doctors treat a communicating hydrocele like a hernia. This surgery is called hydrocelectomy (pronounced hi-druh-see-LEK-tuh-mee).

If your child has surgery, he will get medicine (general anesthesia) to make him sleep without pain during the surgery. The doctors at Seattle Children’s who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to give anesthesia to children safely.

Your child’s surgeon will make a small cut (incision) in the crease between the leg and the lower belly. Then the surgeon will drain the fluid and sew the sac closed. Finally, the surgeon will sew up the incision in the skin. This is not like surgery for an adult hernia, where plastic mesh is needed. All your child needs is to have the sac sewn closed.

The surgery takes about 30 minutes. Your child will be in the recovery room for another hour or so. In most cases, you can take your child home the same day he has surgery.

  • We will give your child pain medicine to make him comfortable. You will need to keep the incision clean and dry until it heals. Your child’s surgical team will teach you how to care for the incision. They will also talk with you about limiting your child’s activity level, if needed.

    A surgery clinic nurse will call you 5 to 7 days after surgery for a phone follow-up. If all is well, you do not need to return to the surgery clinic. If you or the nurse has any concerns about your child’s healing, we will set up a visit for you.

Contact Us

If you have questions about hydrocele treatment, call our General and Thoracic Surgery Department at 206-987-2794. If you would like an appointment, ask your child’s primary care provider for a referral.

Providers, see how to refer a patient.