In Babies

When a fetus is developing in the womb, the testicles develop in the abdomen which descends by the end of a full-term pregnancy. To allow the testicles to descend, a muscle lining (inguinal ring) in the scrotum opens up forming a canal or a sac. Once the testicles reach their normal position, this muscle lining closes. If the inguinal ring stays open or reopens later, fluid can pass from the abdomen through the canal into the scrotum forming a hydrocele.

In Adults

In adults, this condition occurs as a result of an injury or an inflammation (epididymitis). Inflammation can result from an infection in the testicle or in the small coiled tube behind each testicle. This tube is called the epididymis and is responsible for storing and carrying sperm (male reproductive cells that can fertilize a female egg).

It can also occur due to filariasis (an infection caused by filarial parasites leading to obstruction of lymphatic vessels in the scrotum).

There are two types of hydroceles, a communicating hydrocele, and a non-communicating hydrocele.

1. Non-Communicating Hydrocele: Here the narrow canal created by the inguinal ring remains open allowing the fluid to pass back and forth between the abdomen and the membrane of the testicles.
2. Communicating Hydrocele: This forms when the inguinal ring closes but the fluid remains within the membrane of the testicles (sac does not seal). This leads to an increase in the swelling of the scrotum over time.

The main symptom of a hydrocele is swelling on one or both of the testicles.

• In infants, hydroceles usually do not cause any pain. The common symptom with hydrocele is a swollen scrotum. 
• However, in adults, hydrocele can either present as painless swelling or can cause discomfort. As the amount of fluid increases, the scrotum becomes heavier. The discomfort can increase towards the latter part of the day.

If you notice the above-mentioned symptoms in your child or yourself, it is better to consult a doctor. It is important to rule out other causes of the swelling that may include an inguinal hernia. It is a condition where a part of the intestine pushes through a weak spot in the abdomen (tummy) exerting pressure on the scrotum.

Your doctor will:

• Perform a physical examination to check for pain, tenderness, and fluid accumulation around the testicles. 
• Suggest diagnostic tests such as blood tests or an ultrasound (a test that uses high-frequency sound waves for viewing the internal organs) to confirm the diagnosis. 
• Use a method called transillumination, where light is passed through the swelling. If the swelling is fluid-filled like in the case of a hydrocele, the light would pass through it, whereas if it is filled with pus or a hard mass such as a tumour, it would not.

There is no way to prevent your baby from developing a hydrocele. For older children and adults the best way to prevent a hydrocele is to keep your testicles and scrotum free of injury. Those who take part in contact sports should take proper precautions and can use an athletic cup to prevent injuries.

1. Rupture of hydrocele
2. Infection
3. Shrinkage of the testis
4. Infertility
5. Testicular torsion
6. Bleeding in the testicular sac