Hydrocele, Adult

ExitCare ImageFluid can collect around the testicles. This fluid forms in a sac. This condition is called a hydrocele. The collected fluid causes swelling of the scrotum. Usually, it affects just one testicle. Most of the time, the condition does not cause pain. Sometimes, the hydrocele goes away on its own. Other times, surgery is needed to get rid of the fluid.

CAUSES

A hydrocele does not develop often. Different things can cause a hydrocele in a man, including:

  • Injury to the scrotum.

  • Infection.

  • X-ray of the area around the scrotum.

  • A tumor or cancer of the testicle.

  • Twisting of a testicle.

  • Decreased blood flow to the scrotum.

SYMPTOMS

  • Swelling without pain. The hydrocele feels like a water-filled balloon.

  • Swelling with pain. This can occur if the hydrocele was caused by infection or twisting.

  • Mild discomfort in the scrotum.

  • The hydrocele may feel heavy.

  • Swelling that gets smaller when you lie down.

DIAGNOSIS

Your caregiver will do a physical exam to decide if you have a hydrocele. This may include:

  • Asking questions about your overall health, today and in the past. Your caregiver may ask about any injuries, X-rays, or infections.

  • Pushing on your abdomen or asking you to change positions to see if the size of the hydrocele changes.

  • Shining a light through the scrotum (transillumination) to see if the fluid inside the scrotum is clear.

  • Blood tests and urine tests to check for infection.

  • Imaging studies that take pictures of the scrotum and testicles.

TREATMENT

Treatment depends in part on what caused the condition. Options include:

  • Watchful waiting. Your caregiver checks the hydrocele every so often.

  • Different surgeries to drain the fluid.

  • A needle may be put into the scrotum to drain fluid (needle aspiration). Fluid often returns after this type of treatment.

  • A cut (incision) may be made in the scrotum to remove the fluid sac (hydrocelectomy).

  • An incision may be made in the groin to repair a hydrocele that has contact with abdominal fluids (communicating hydrocele).

  • Medicines to treat an infection (antibiotics).

HOME CARE INSTRUCTIONS

What you need to do at home may depend on the cause of the hydrocele and type of treatment. In general:

  • Take all medicine as directed by your caregiver. Follow the directions carefully.

  • Ask your caregiver if there is anything you should not do while you recover (activities, lifting, work, sex).

  • If you had surgery to repair a communicating hydrocele, recovery time may vary. Ask you caregiver about your recovery time.

  • Avoid heavy lifting for 4 to 6 weeks.

  • If you had an incision on the scrotum or groin, wash it for 2 to 3 days after surgery. Do this as long as the skin is closed and there are no gaps in the wound. Wash gently, and avoid rubbing the incision.

  • Keep all follow-up appointments.

SEEK MEDICAL CARE IF:

  • Your scrotum seems to be getting larger.

  • The area becomes more and more uncomfortable.

SEEK IMMEDIATE MEDICAL CARE IF:

You have a fever.