A hydrocele is a collection of fluid in the scrotum. Most develop for no apparent reason and are harmless and can be left alone. If needed, a small operation can usually cure the problem. In a small number of cases, a hydrocele is due to an underlying problem with a testicle.
The Normal Scrotum and Testes:
The scrotum is normally loose, soft and fleshy. It holds the two testicles. Usually you can easily feel your testes in your scrotum. A tube (the vas deferens) takes sperm from each testicle to the penis. It is normal for one testis to hang lower than the other.
What is a Hydrocele?
A hydrocele is a collection of fluid in a sac in your scrotum next to a testicle. It usually occurs on one side but sometimes a hydrocele forms over both testicles.
The normal testis is surrounded by a smooth protective tissue sac. You cannot normally feel this. It makes a small amount of ‘lubricating’ fluid to allow the testes to move freely. Excess fluid normally drains away into the veins in your scrotum. If the balance is changed between the amount of fluid that is made and the amount that is drained, some fluid accumulates as a hydrocele.
What Do Hydroceles Look and Feel Like?
A hydrocele feels like a small fluid-filled balloon inside your scrotum. It feels smooth and is mainly in front of one of your testicles .
Hydroceles vary greatly in size. Very large hydroceles are sometimes seen in elderly men who have never shown their swelling to a doctor. There is a possibility that it may have been getting larger over a number of years.
Hydroceles are normally painless, however larger hydroceles may cause discomfort because of their size. Walking or sexual activity may become uncomfortable if you have a very large hydrocele.
What Causes Hydroceles?
Most hydroceles occur in adults and are most common in men aged over 40 years.
• The cause is not known in most cases.
• A small number of hydroceles are caused when something is wrong with one of the testicles. For example, infection, inflammation, injury or tumors of your testicle may cause fluid to be formed which leads to a hydrocele forming.
• Sometimes hydroceles develop when there is a generalised swelling of the lower half of your body due to fluid retention.
Are Any Tests Needed?
A doctor will examine your testicles and may also shine a light through your scrotum, which helps to diagnose a hydrocele.
What are the Treatments for Hydrocele?
• Leaving it Alone
In adults, if the hydrocele causes no symptoms, one option is simply to leave it alone. If it becomes larger or troublesome, you can always change your mind and have treatment.
Surgery may be recommended if your hydrocele is large or uncomfortable. The operation for a hydrocele involves making a very small cut in the scrotum or lower tummy (abdominal) wall. The fluid is then drained from around the testicle.
The fluid can be drained easily with a needle and syringe. However, following this procedure, it is common for the sac of the hydrocele to refill with fluid within a few months. Draining every now and then may be suitable though, if you are not fit for surgery or if you do not want an operation.