What is a hydrocele?

A hydrocele is a collection of watery fluid around the testicle. It is common in young boys and gets attention due to testicle swelling in a child. The affected size looks bigger than the other side and is often painless.

Why does hydrocele happen in children?

Hydrocele is a common problem in newborn males and usually goes away within the first year of life. When the testicle drops into the scrotum (about the eighth month of pregnancy), a sac or a tube (the processus vaginalis) from the abdominal cavity travels along with the testicle leaving an open connection. Fluid can then flow through this connection to the scrotum to surround the testicle. This sac usually closes in first two years of life, and the fluid is absorbed.

What are the types of hydrocele in a boy?

• Non Communicating hydrocele: When the sac closes and the fluid remains around scrotum causing swelling, this is called a noncommunicating hydrocele. This means that the scrotal sac can be compressed, and the fluid will not flow back into the abdomen. This type of hydrocele is often found in newborns and the fluid will usually be absorbed with time.
• Communicating Hydrocele: If the scrotal sac is compressed and the fluid slowly goes back up into the abdomen or if the hydrocele changes size, this is called a communicating hydrocele. This type of hydrocele usually appears smaller in the morning when the child wakes up and larger in the evening after activity. A communicating hydrocele shows that the sac or processus vaginalis is still open.

When is surgery recommended for hydrocele in a child?

Surgery is recommended in a child if the hydrocele is still present after 18 months- 2 years of age. Hydroceles that continue to get larger are symptomatic and should be fixed.

What Surgery is done for hydroceles?

The surgery for hydroceles is same as that for hernia and is called Herniotomy. The repair of hydrocele involves making a small cut in inguinal region and then closing the tube connection. Also, the fluid in scrotum is evacuated and if the sac is larger, it is a good idea to leave the sac widely open so that hydrocele doesn’t come back again

Can hydrocele come back again?

If the connection is not closed properly or in a large hydrocele, the sac around testis is not widely opened, sometimes hydrocele can come back again. Hence it is important that these surgeries are best done by an expert pediatric urologist surgeon for good results and less complications.

Watch Inguinal hernia repair surgery in a boy by Dr A.K.Singal