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Congenital Hydrocele

Topic Overview

What is a hydrocele?

A hydrocele (say "HY-druh-seel") is a buildup of watery fluid around one or both testicles. It causes the scrotum or groin area to swell.

A congenital hydrocele is one that a baby is born with. Hydroceles can also occur later in life for a number of reasons. This topic is about congenital hydroceles, which are common in male newborns.

The swelling from a hydrocele may look scary, but it is usually not a problem. It will probably go away by the time your baby is 2 years old.

What causes a congenital hydrocele?

A month or so before birth, a baby's testicles move from the belly area down into the scrotum, along with a bit of the lining of the belly area. The lining shrivels up, leaving a small empty space around the testicles. This space normally closes up by the time a baby is 2 years old.

Sometimes fluid leaks into the space, filling it like a small water balloon. This is a hydrocele. When the space closes up and traps the fluid inside, it's called a noncommunicating hydrocele. Usually, the body absorbs the fluid over time.

If the space doesn't close up the way it should, the fluid moves back and forth between the scrotum and the belly area. This is called a communicating hydrocele. The swelling comes and goes. This problem is usually fixed with surgery to help prevent a hernia in the groin.

Another type of hydrocele is a hydrocele of the spermatic cord. It is located higher up in the scrotum. The fluid is usually absorbed within a few months and at the latest by age 1 or 2. A hydrocele of the cord may be mistaken for an inguinal hernia.

What are the symptoms?

The usual symptom is a swollen scrotum. The swelling does not hurt. If your child seems to be in pain, call the doctor. Pain may mean that your child has a hernia or other problem.

How is a congenital hydrocele diagnosed?

Doctors diagnose a congenital hydrocele during a physical exam that includes questions about the child's health. The swelling is often easy to see, so the hydrocele is typically not hard to identify. But the doctor will want to rule out other conditions.

How is it treated?

Most of the time, all you need to do is watch for changes in the swelling. If the swelling gets bigger or if it comes and goes, tell your doctor.

Your child may need surgery to remove the fluid if:

  • He still has the hydrocele at age 2.
  • The swelling comes and goes.
  • The swelling causes pain.
  • The swelling gets worse.

If surgery is needed, the doctor or nurse will give your child medicine to make him or her sleep. A small cut (incision) will be made in the groin area. At the end of the surgery, the cut will be stitched up. The doctor may ask you if you want him or her to check the opposite groin area for a hydrocele or other problem during the same surgery. After surgery, you'll need to care for the groin incision and watch for signs of infection.

Frequently Asked Questions

Learning about congenital hydrocele:

When surgery is needed for congenital hydrocele:

Other Places To Get Help

Organization

Urology Care Foundation: The Official Foundation of the American Urological Association
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: 1-800-828-7866
Phone: (410) 689-3700
Fax: (410) 689-3998
Email: info@urologycarefoundation.org
Web Address: www.urologyhealth.org
 

UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.

The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology A–Z page to find information about urologic problems.


References

Other Works Consulted

  • Elder JS (2011). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1858–1864. Philadelphia: Saunders.
  • Koski ME, et al. (2010). Infant communicating hydroceles—Do they need immediate repair or might some clinically resolve? Journal of Pediatric Surgery, 45(3): 590–593.
  • Zderic SA, Lambert SM (2010). Developmental abnormalities of the genitourinary system. In CA Gleason, SU Devaskar, eds., Avery's Diseases of the Newborn, 9th ed., pp. 1191–1204. Philadelphia: Elsevier Saunders.

Credits

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Specialist Medical Reviewer Peter Anderson, MD, FRCS(C) - Pediatric Urology
Last Revised December 28, 2012

Last Revised: December 28, 2012

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