Hydrocele

Hydrocele is a painless collection of fluid in and around one or both testicles. It is usually a harmless condition, which can affect male children and adults. A Hydrocele may be congenital (present at birth) or acquired (developing after birth). 10% of all male new babies are born with Hydrocele, which usually disappear without any treatment by the age of 1 year. Adult males can develop Hydrocele because of trauma or inflammation. It can occur at any age but is most common in men over age 40.

The testis is located in a bag like structure called scrotum. Fluid collects between the coverings of scrotal sac and causes painless gradual increase in scrotal size or causes the groin area to swell. It may effect one or both testicles. Large swellings can cause discomfort, especially while walking. 

Causes 

1. Congenital-babies are born with Hydrocoele and this can resolve without any treatment by the end of first year.
   

2. Hydrocoele can occur in adults because of trauma, blood obstruction, inflammation, tumor or radiation therapy.
   

3. An acquired Hydrocele may be caused by an injury to the groin area or by an unknown cause.
   

Diagnosis 

• Physical Examination shows swelling scrotum. Testicles may or may not be felt because of  the surrounding fluid.
   

• Transillumination is a test which is done by shining a bright light through the scrotum. Scrotum usually lights up in Hydrocele.
  

• Ultrasound can confirm the diagnosis of Hydrocoele.
  

Treatment 

Small asymptomatic Hydrocoele requires no treatment. This condition needs treatment by removal of the fluid only if the swelling becomes uncomfortably large.

Large Hydrocoele may be intervened by 

1. Hydrocele sac may be aspirated by a needle. 
   

2. Surgical removal called Hydrocelectomy may be required in recurrent cases or if the fluid returns even after removal with a needle. Hydrocelectomy is a minor surgical procedure where an incision may be made in the scrotum or the lower abdomen, under general or spinal anesthesia.