A hydrocele (fluid around the testicle) may be congenital, or it may develop only later in childhood or in adult men. In a congenital hydrocele (also called a primary hydrocele), the peritoneum above the scrotum does not close properly, allowing fluid from the abdominal cavity to seep down to the testicles.

A congenital hydrocele often resolves within a certain period after birth, because the body usually clears the fluid on its own.

A hydrocele acquired in childhood or adulthood (also called a secondary hydrocele) can have various causes, for example:

  • hernias
  • blunt force, such as kicks or punches
  • operations
  • inflammation of the testicles, epididymis or spermatic cord
  • testicular torsion
  • testicular tumours

It is not always possible to find the cause of an acquired hydrocele, however; sometimes it develops for no apparent reason.

A hydrocele must always be diagnosed and treated, as it can sometimes mask a quite different and more serious condition.

Hydrocele is treated surgically, by an operation known as a hydrocelectomy. A hydrocelectomy is performed to remove the scrotal swelling caused by fluid accumulating around the testicle, that is, the hydrocele. Treatment in Switzerland is renowned for its highly qualified surgeons, who can free you or your child of a hydrocele quickly and without after-effects.

What are the symptoms of a hydrocele?

A hydrocele most often shows as swelling of the scrotum. It feels firm and elastic but is usually painless. Depending on its size, however, a hydrocele may hinder movement.

With a congenital hydrocele, the swelling increases when the child is held upright or cries, and decreases again when the child lies down.

How is a hydrocele diagnosed?

To detect a hydrocele, doctors palpate the affected side of the scrotum. They assess the size of the swelling and check whether it feels distended and elastic. They also ask whether there has been an accident or whether certain conditions are present. An ultrasound examination is usually used to make an accurate diagnosis.

Medical examination and ultrasound make it possible to rule out other conditions, such as varicose veins of the testicle (varicocele), testicular torsion or testicular cancer. Special laboratory tests are also available to rule out cancer.

Treating a congenital hydrocele

If a hydrocele in a newborn is not too large, it usually needs no immediate treatment. Its development is monitored over several months, sometimes up to the age of two. In most cases, the connection between the abdominal cavity and the scrotum closes on its own during this time, and the body clears the accumulated fluid again.

If this does not happen, the opening is closed surgically in the second or third year of life. If the problems are very serious, earlier surgery may be recommended.

Treating an acquired hydrocele

An acquired hydrocele in adult men requires surgery. After a hydrocele operation, the patient does not need to stay in hospital for long, but once he leaves he should remember a few simple rules. Above all, he should take things easy for several weeks after the operation, as swelling and tenderness of the scrotum may be present during this time. He should therefore avoid tight underwear and physical exertion. This allows the pain and swelling to subside much more quickly. About a week after the operation, he should return to the surgical clinic for a check-up.