A hydrocele is a build-up of fluid in the membrane that surrounds the testicle. The fluid drains from the abdomen through a channel into the scrotum.

Types of hydrocele include:

  • Communicating—present at birth, generally found in infants and young children
  • Noncommunicating—acquired, occurs at any age

Male Anatomy

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A communicating hydrocele occurs during fetal development. Testicles develop in the abdomen. They eventually move into the scrotum through a small channel. This channel should close after the testicles pass through it. When the channel does not close, fluid can pass from the abdomen into the membrane covering the testicle.

A noncommunicating hydrocele may be caused by an injury or infection that causes fluid build-up. It can also be a complication of surgery. In some cases, the cause is unknown.

Risk Factors

Factors that may increase the chance of a hydrocele include:

  • Premature birth
  • Injuries to the testicles and/or scrotum
  • Infections, including those that are sexually transmitted

A hydrocele may not always cause symptoms. When they do appear, a hydrocele may cause:

  • Swelling of the scrotum
  • Feeling of heaviness or soreness in the scrotum
  • Swelling with activity or standing—especially with a communicating hydrocele

The doctor will ask about any symptoms and medical history. A physical exam will be done. A hydrocele is usually diagnosed by physical exam. The doctor may want to do tests to confirm a cause or rule out other conditions.

Tests may include:

  • Transillumination—A bright light is shined through the swollen part of the testicle. A hydrocele will allow light to pass through it.
  • Ultrasound—May be done if the diagnosis is unclear.

Treatment options include:

Watchful Waiting

A communicating hydrocele generally goes away on its own during the first year of life. A noncommunicating hydrocele may also resolve on its own or with treatment of related condition. Watchful waiting is simple monitoring for any changes.


Fluid may be removed by with a needle. It may be done for a large hydrocele that causes discomfort or obstruction. Aspiration may need to be done more than one time because fluids can return.

For adults with a hydrocele, fluid aspiration may followed by sclerotherapy. A needle is inserted into the same area with a sclerosing agent. The agent causes scar tissue in the channel which blocks the flow of fluid.


A hydrocelectomy may be advised if the hydrocele:

  • Remains or develops after first year of life
  • Becomes large enough to threaten testicular blood supply or to cause discomfort
  • Is associated with a hernia

During a hydrocelectomy to treat a noncommunicating hydrocele, an incision is made into the scrotum (or groin area). During a hydrocelectomy to treat a communicating hydrocele, it is made in the groin. The fluid is drained and the hydrocele is removed. Surgery usually corrects the problem without recurrence.


There are no current guidelines to prevent a hydrocele.