What is a Hydrocoele?
A hydrocoele is a collection of fluid that forms around the testicle within the scrotum, causing swelling of the scrotum. It is usually painless and benign (non-cancerous).
Hydrocoeles can occur in men of any age, but they are most common in newborn babies and older men.
Hydrocoele
Symptoms
The most common symptom of a hydrocoele is:
Painless swelling of the scrotum
Other features may include:
Gradual enlargement of the scrotum
A feeling of heaviness or discomfort in the scrotum
Swelling that may change in size during the day
Occasionally mild discomfort if the hydrocoele becomes large
Hydrocoeles are usually not painful, but large hydrocoeles can cause inconvenience or pressure.
Causes
In many cases, the exact cause of a hydrocoele is unknown.
Possible causes include:
Idiopathic Hydrocoele
Most adult hydrocoeles develop without a clear cause.
Inflammation or Infection
Inflammation of the testicle or epididymis may lead to fluid accumulation.
Injury or Trauma
Previous injury to the scrotum can sometimes result in a hydrocoele.
Following Surgery
Hydrocoeles may develop after certain operations involving the scrotum or groin.
In Infants
In babies, hydrocoeles occur when the channel between the abdomen and scrotum (processus vaginalis) does not fully close before birth.
How is a Hydrocoele Diagnosed?
Diagnosis usually involves a physical examination by your doctor.
Physical Examination
Your doctor will examine the scrotum and may shine a light through the swelling. This is called transillumination and can help identify fluid around the testicle.
Ultrasound Scan
A scrotal ultrasound is often performed to confirm the diagnosis and ensure that the testicle itself is normal.
Ultrasound can also help exclude other conditions such as:
Testicular tumours
Epididymal cysts
Hernias
Do Hydrocoeles Need Treatment?
Small hydrocoeles that cause no symptoms may not require treatment and can simply be monitored.
Treatment may be recommended if the hydrocoele:
Becomes large or uncomfortable
Causes cosmetic concerns
Interferes with daily activities
Causes uncertainty about the diagnosis
Treatment Options
Surgical Repair (Hydrocelectomy)
The most effective treatment is a hydrocelectomy, a surgical procedure to remove the hydrocoele.
During the operation:
An incision is made in the scrotum or groin
The fluid is drained
The sac that produced the fluid is removed or repaired to prevent recurrence
The procedure is usually performed under general anaesthetic.
Most patients go home the same day or the following day.
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Needle Drainage (Aspiration)
In some cases, the fluid can be removed using a needle and syringe.
However, this is usually not a permanent solution, as the fluid often returns. It may occasionally be considered for patients who are not suitable for surgery.
Recovery After Surgery
After hydrocoele surgery:
Mild swelling and bruising of the scrotum is common
Discomfort usually improves within a few days
Supportive underwear may be recommended
Heavy lifting and strenuous activity should be avoided for 2–3 weeks
Full recovery usually occurs within a few weeks.
Possible Risks of Surgery
Hydrocoele surgery is generally safe, but possible complications include:
Bleeding or scrotal swelling
Infection
Recurrence of the hydrocoele
Injury to surrounding structures (rare)
Your surgeon will discuss these risks with you before the procedure.
When to See a Doctor
You should seek medical advice if you notice:
Swelling in the scrotum
A lump in the testicle
Sudden pain or discomfort in the scrotum
Rapid increase in scrotal size
Any new scrotal swelling should be assessed by a doctor to rule out other conditions.
