Kidney, Reproductive and Urinary Conditions

Hydrocele

What is hydrocele?

A hydrocele (pronounced HI-druh-seal) is a swelling in a boy’s scrotum. It is caused by fluid that builds up in the scrotum. Hydroceles are common in newborns. Most go away by the time a baby is 1. Older boys can get hydroceles if their scrotum has been injured or is inflamed due to an infection.

  • Most hydroceles are present when a baby is born. Before a baby is born, their testicles move from the belly (abdomen) into the scrotum. Most of the time, the sac around each testicle closes and the baby’s body absorbs any fluid inside the sac.

    Sometimes fluid stays in the sac after it closes. This is called a noncommunicating hydrocele. Most of the time, this fluid is absorbed slowly during the first year of life.

    Sometimes the sac stays open. Fluid can flow between the scrotum and belly. This is called a communicating hydrocele. It can lead to an inguinal hernia.

Hydrocele at Seattle Children’s

Doctors in our Pediatric General and Thoracic Surgery and Urology programs are experts and highly skilled in treating hydroceles. Each year, we take care of hundreds of boys who have hernias and hydroceles.

If you would like to schedule a visit or have questions about hydrocele treatment, contact our General and Thoracic Surgery Department at 206-987-2794.

    • Our surgeons understand how treatments today affect growing bodies in the future. They are specially trained to meet the needs of children and teens.
    • Experience counts. More cases mean our surgeons have greater skill and can best decide if surgery is even needed. All that adds up to better outcomes.
    • How your child’s pain is managed after surgery is key to their healing. We have the largest team of anesthesiologists who treat only children. Seattle Children’s is 1 of just 5 hospitals in the nation recognized by ChildKind International for how well we prevent and treat pain in children.
    • When you come to Seattle Children’s, you have a full team behind you, before, during and after surgery. You will get support from child life specialists, social workers and others.
    • Our team takes time to explain your child’s condition and answer all your questions. We help you fully understand your treatment options and make choices that are right for your family.
    • At Seattle Children's, we work with children and families from around the Northwest and beyond. 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

Often, the only symptom is swelling of the scrotum. Your child’s scrotum may change size over the course of the day.
Hydroceles rarely cause pain. In older boys, swelling may cause discomfort.
It is important to find out if a hydrocele or something else is causing the swelling, especially if the scrotum has been injured.
Take your son to the doctor right away if he has sudden, severe pain and swelling in his scrotum. A twisted testicle (testicular torsion) and some types of inguinal hernia need treatment right away.

Diagnosing Hydrocele

Your child’s doctor will:

  • Check your child’s belly area and groin.
  • Look and feel to see if the scrotum is swollen.
  • Try to feel your child’s testicles. Sometimes the doctor cannot feel the testicles because the scrotum has so much fluid.
  • Press gently on your child’s belly or scrotum to see if the scrotum changes in size.

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, your child might have a hernia.

Rarely, the doctor might do an ultrasound exam to make sure of the diagnosis.

Treating Hydrocele

Neither type of hydrocele is dangerous. Noncommunicating hydroceles usually go away on their own. Doctors suggest surgery only if the hydrocele is still present when your child turns 1.

Most of the time, communicating hydroceles are fixed with surgery because they can lead to hernias. Doctors will often suggest surgery soon after they diagnose a hydrocele.

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

    Before surgery, your child will get medicine (general anesthesia) to make him sleep without pain. 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 pain medicine to children safely.

    Your child’s surgeon will:

    • Make a small cut (incision) in the crease between the leg and the lower belly
    • Drain the fluid
    • Sew the sac closed
    • 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 an hour or so. We will give them pain medicine for comfort.

  • Usually, you can take your child home the same day he has surgery.

    Before you leave the hospital, we will:

    • Teach you how to care for your child’s incision by keeping it clean and dry
    • Explain any medicine he will need
    • Tell you if you need to limit his activity

    Read about home care after surgery for hydrocele (PDF)

    A surgery clinic nurse will call you 5 to 7 days after surgery to check how your son is doing.

    • If all is well, you do not need a follow-up visit.
    • 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 would like an appointment or have questions about hydrocele treatment, call our General and Thoracic Surgery Department at 206-987-2794.

To make an appointment, you can call us directly or ask your child’s primary care provider to refer you. We encourage you to coordinate with your regular doctor when coming to Seattle Children’s.

Providers, see how to refer a patient.