Hydrocele in Children

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A hydrocele is a swelling surrounding your child’s testicle in the scrotum that is caused by a buildup of fluid. Hydroceles may develop in either testicle. The swelling may be significant but is usually painless.

Hydroceles most commonly occur in infants, but they can form at any age.

How Hydroceles Form

Hydroceles most commonly develop while your child is still in the womb. As a fetus, your child has a tube from the inside of the abdomen to the genitals. This tube allows the testicles, which develop in the abdomen, to move down to the scrotum. Eventually, the canal forms part of the sac that surrounds the testicles in the scrotum, and the canal closes off from the abdomen. During this process, fluid may become trapped within the sac in the scrotum, forming a hydrocele.

However, hydroceles may form at any age as a result of other conditions, such as infection, twisting of the testicles (torsion) or a tumor.

There are two types of hydroceles:

  • Communicating hydroceles connect to the inside of the abdomen through a tube, which allows fluid to move in and out of them; this changes the size of the swelling throughout the day.
  • Noncommunicating hydroceles aren’t connected to the abdomen; these are often present at birth and usually go away with no treatment within a year.

The symptoms of a hydrocele include:

  • A lump or swelling in your child’s scrotum that is smooth and painless
  • Your child’s scrotum gets smaller while resting and larger during activity

Diagnosis & Treatment at UVA

Your child’s provider will examine your child’s scrotal swelling to determine if it is an inguinal hernia or a hydrocele using:

  • Ultrasound
  • Transillumination (a strong light shone on one side of the swelling shows if light passes through)

We can treat hydroceles with surgery, draining the fluid and closing any opening allowing fluid to accumulate in the scrotum. Without any treatment, some hydroceles get better and go away; however, an untreated hydrocele may develop into a hernia.