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The Facts About Hydroceles

Find out how a hydrocele affects your sexual health.

An x-ray of a testicle shows a hydrocele in yellow.

When everything is going well, men rarely worry about their genitals. They may think about them in various ways, but worry? Probably not.

Most of them definitely don't worry about a hydrocele, mostly because they probably don't know what it is and how it can affect their sexual health.

What is a hydrocele?

A hydrocele occurs when fluid accumulates around one or both testicles. Fluid from the abdominal cavity gets trapped within a membrane that surrounds the testicle, causing it to appear to be larger.

The fluid can cause the scrotum to appear swollen, and it can be uncomfortable or a source of embarrassment, but it's typically not a serious health issue.

About 10 percent of infants are born with a hydrocele, and they often go away on their own within the first year, according to Cleveland Clinic. They only occur in about 1 percent of adult men.

What causes a hydrocele?

A hydrocele is simply the accumulation of abdominal fluid around the testicle. The fluid reaches the scrotum and testicles due to a connection with the lower abdomen that remains open longer than it is supposed to. The fluid gets trapped within a membrane called the processus vaginalis that extends down into the scrotum from the abdomen. It then forms a pocket of fluid around the testicle.

This opening to the abdomen through which the processus vaginalis extends is called the inguinal canal. It's where the testicles descend into the scrotum during gender differentiation in the womb. The inguinal canal and the processus vaginalis are the fundamental structures for understanding the two types of hydrocele: communicating and noncommunicating.

Communicating hydrocele

If the processus vaginalis remains open and allows fluid to move back and forth from the abdomen to the scrotum, it's called a communicating hydrocele. The hydrocele may change size at different times of the day or depending on what kind of activity the person is engaged in, and this may make the scrotum appear to change in size.

Noncommunicating hydrocele

A noncommunicating hydrocele occurs when the processus vaginalis has closed but not before some fluid from the abdomen has become trapped around a testicle. Usually, these types of hydroceles remain about the same size or only grow very slowly.

Hydroceles in infants and adults

About 10 percent of baby boys are born with a hydrocele. They often resolve over the course of the child's first year of life. Although the condition is much more common in newborns and infants, adult men and adolescents may also develop them.

Only about 1 percent of older males will develop a hydrocele. When they do occur in older males, the cause is often trauma or injury to the scrotum, according to Mayo Clinic. Another reason they may develop later in life is an infection or inflammation. For instance, an infection of the epididymis can sometimes cause a hydrocele to develop.

Symptoms of hydroceles

The primary symptom of a hydrocele is swelling in one or both testicles. Adults may notice the swelling, but it may be painless. It may give you a sense of discomfort or heaviness in your scrotum. As the hydrocele develops, it may become more painful as it presses on the testicle.

You may also notice that it changes size throughout the day depending on how active you are. For instance, it may be smaller in the morning after lying down all night and larger in the afternoon after spending the day on your feet.

Parents of infants should contact a healthcare provider if they notice their child is in pain or if they see a lump in the baby's scrotum or just above it. Pain, nausea, vomiting or a loss of appetite could be signs that part of the intestine has entered the scrotum along with some abdominal fluid. This is called an inguinal hernia and may require surgical repair.

It's especially vital to get prompt medical attention if your child has sudden, severe pain or swelling in the scrotum, especially if it's shortly after an injury to the groin. These symptoms can be a sign of testicular torsion, which can block blood flow to the testicle and result in the death of the testicle within hours if it isn't repaired surgically.

Diagnosis and testing

To diagnose a hydrocele, your healthcare provider will likely begin with a history of recent events. This investigation may include when you first noticed the bulge in your testicle, whether there's pain and if it has changed size throughout the day.

Your doctor will likely then do a physical examination to see if the bulge changes shape and size under pressure or when you cough. They may also press on your lower abdomen or upward from your scrotum to check for an inguinal hernia.

Another helpful diagnostic tool is shining a flashlight through the scrotum, as this can reveal the fluid sac alongside the testicle.

Your provider may also order a scrotal ultrasound to better delineate a potential hydrocele from what could be another kind of scrotal mass (i.e., spermatocele or complex hydrocele).

How to treat a hydrocele

Unfortunately, there is no medication that can specifically cure a hydrocele. Typically, a hydrocele will resolve on its own and not require any further intervention, especially in an infant.

Parents should have their baby examined by a healthcare provider if they notice any lumps or swelling in the groin. Don't just assume it's a hydrocele, because it could be a more serious condition.

Sometimes, a hydrocele may not resolve on its own and could require further intervention. One treatment is hydrocelectomy, in which the surgeon makes an incision in the scrotum and drains the hydrocele using suction. The doctor then closes the membrane and, if it's a communicating hydrocele, closes the portal between the scrotum and the abdomen.

For men who are at higher risk for going under general anesthesia, the provider may opt for needle aspiration, in which they administer local anesthesia and use a long needle to drain the hydrocele. They then inject medication into the area to prevent it from filling up again.

Potential complications

Hydroceles aren't typically dangerous and they shouldn't affect a man's fertility. However, there are cases in which the appearance of a hydrocele is associated with another more serious condition.

Certain tumors and infections may cause a hydrocele, and if it's associated with an inguinal hernia, this can develop into a life-threatening situation if it's left untreated.

One of the most common complications is that the hydrocele will return. Even if it doesn't, some men experience residual swelling for weeks during the recovery period after hydrocelectomy, which is normal.


The outlook for someone with a hydrocele is very positive. Hydroceles usually resolve on their own, and the cases that do require surgery are associated with a very positive outcome. You should be able to live a perfectly normal life when you have a hydrocele.

As you wait for an adult hydrocele to resolve itself, you can help alleviate some of the discomforts by wearing supportive undergarments, such as compression underwear or a jockstrap.


What is the main cause of a hydrocele?

Most hydroceles occur in infants and newborns. This is because when the testicles descend into the scrotum during the child's development in the womb, a membrane surrounding the testicle may bring some abdominal fluid down with it. In adults, a hydrocele is typically caused by some kind of groin trauma or a separate condition such as a tumor or infection.

How do you get rid of a hydrocele?

Most hydroceles resolve on their own over time. However, in cases where they don't go away, a urologist may suggest a surgical procedure called hydrocelectomy to suction out the fluid or a needle aspiration from the outside of the scrotum.

What happens if the hydrocele is not treated?

Typically, hydroceles resolve on their own, but in some cases, they may be associated with other conditions that can cause complications if left untreated, such as inguinal hernia, infections, sexually transmitted infections (STIs) and more.