Hydrocele, Infant

A hydrocele is a painless collection of clear fluid surrounding the testis. It is common in newborn males. It may take up to 6 - 12 months to get better. It is usually harmless but can be checked during regular visits to your caregiver. It is also spelled "hydrocoele".

CAUSES

The testicles initially develop in the belly (abdomen). The testicles move down into the scrotum before birth. As they do this, some of the lining of the abdomen comes down as a tube with the testes. This tube connects the abdomen to the scrotum but is usually closed at birth. However, sometimes, it remains open.

A hydrocele forms either because fluid produced in the abdomen:

  • Was trapped in the scrotum when the tube closed (most common hydrocele).

  • Can pass back and forth between the scrotum and abdomen because the tube is still open (communicating hydrocele).

SYMPTOMS

Most hydroceles cause no symptoms other than swelling in the scrotum. They are not painful. A communicating hydrocele often causes changes in size of the scrotum. The hydrocele is usually smaller in the morning. It grows larger during the day as it fills with fluid.

DIAGNOSIS

Your baby's caregiver will most often be able to identify a hydrocele by examining the scrotum. Ultrasound can be used if the diagnosis is uncertain.

TREATMENT

  • Most hydroceles will close by the age of 1 year. Surgery is usually unnecessary in babies.

  • Corrective surgery is usually recommended if:

  • The hydrocele is not gone after one year of age.

  • The hydrocele is very large, tense or uncomfortable.

  • Sometimes a hernia will be present with a hydrocele. This means a loop of bowel has slipped down through the open tube between the belly and the scrotum. This is usually not serious but does need surgical correction.

  • If the intestine gets stuck in the open tube or scrotum and becomes blocked, it then becomes an emergency.

  • When this happens, your baby may cry persistently, have vomiting, and his abdomen may become bloated. The hernia bulge may become larger, firmer, or red and tender to touch.

SEEK MEDICAL CARE IF:

  • Your child's swelling changes during the day (smaller in the morning and larger at night).

  • There is swelling in the groin.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your baby begins vomiting repeatedly.

  • There is persistent crying.

  • The bulge in the scrotum or groin becomes larger, firmer, or red and tender to touch. This is an emergency and requires immediate attention!