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.
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.
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.
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.