A hydrocele is a buildup of fluid around the testicle. This buildup of fluid can cause swelling and cause pain in the testicles (scrotum).
The testes or testicles are part of the male reproductive system that functions to produce sperm and the hormone testosterone. This pair of testes is in the scrotal pouch and hangs just below the base of the penis.
Normally, the scrotum will feel tight but not hard. In people with hydrocele, the scrotum will feel soft like a balloon filled with water to the touch.
Hydrocele usually occurs in newborn boys, but can also be experienced by adult men. Although generally harmless, a doctor's examination is still necessary to rule out the possibility that a hydrocele is caused by a serious disease, such as testicular cancer.
Hydrocele Type
Hydrocele is divided into 2 types, namely:
- Non-communicating hydrocele
This hydrocele occurs when the gap between the abdominal cavity and the scrotum (inguinal canal) closes, but the fluid in the scrotum is not absorbed by the body.
- Communicating hydrocele
This hydrocele occurs when the inguinal canal does not close so that fluid from the abdominal cavity continues to flow into the scrotum and can rise back up into the abdomen. Communicating hydrocele may be accompanied by an inguinal hernia.
Causes of Hydrocele
The causes of hydrocele in infants and men are different. Here's the explanation:
Hydrocele in babies
In infants, hydrocele occurs due to developmental abnormalities while the baby is still in the womb. This disorder causes a buildup of fluid in the scrotum.
While in the womb, the fetal testes that were originally in the abdomen will descend into the scrotum through the gap between the abdominal cavity and the scrotum. The two testes descend into the scrotum along with the fluid.
Normally, this gap, called the inguinal canal, will close in the first year after the baby is born. The fluid in the scrotum will also be gradually absorbed by the baby's body by itself.
In infants with hydrocele, the process does not run normally, where the inguinal canal does not close so that the scrotum remains filled with fluid and swells.
Hydrocele in adult men
In contrast to baby boys, hydrocele in adult men can be caused by a number of conditions:
- Inguinal hernia surgery
- Injury or impact on the scrotum
- Elephantiasis (filariasis)
- Inflammation of the sperm ducts (epididymitis)
- testicular tumor
Hydrocele risk factors
Hydrocele in infants is more at risk for babies born prematurely. Whereas in adult men, the risk of hydrocele will increase if they have the following conditions:
- Suffering from sexually transmitted diseases
- Have an injury or inflammation of the scrotum
Hydrocele Symptoms and Signs
In infants, hydrocele is characterized by swelling on one or both sides of the scrotum. If palpated, the scrotum will feel soft like a balloon filled with water. This swelling is usually painless and will deflate on its own.
In adult men, in addition to swelling of the scrotum, a swollen hydrocele will be uncomfortable or heavy. Sometimes the swelling of the scrotum is more noticeable in the morning.
When to go to the doctor
Check with your doctor if you experience the complaints and symptoms as mentioned above.
You should also see a doctor immediately if you experience the following conditions:
- The scrotum swells suddenly and swells rapidly.
- Severe pain that appears suddenly in the scrotum even though it is not swollen.
- Pain or swelling in the scrotum appears several hours after the injury.
- Hydrocele in infants does not disappear or enlarge after 1 year of age.
Hydrocele Diagnosis
To determine whether the patient has a hydrocele, the doctor will perform a physical examination of the scrotum by:
- Pressing the swollen scrotum, to determine the level of hardness
- Pressing on the abdomen and scrotum, to detect possible symptoms of an inguinal hernia
- Illuminate the testicles with a lamp whose light penetrates into the scrotum (transillumination), to see the presence of fluid in the scrotum
If the doctor suspects that the swelling of the scrotum is caused by an infection, then urine and blood tests will be done to confirm the suspicion. But if swelling of the scrotum is suspected due to a hernia or testicular tumor, the doctor will perform an ultrasound on the testicles.
Hydrocele Treatment
Hydrocele in infants will usually disappear by itself after the baby is one year old. While hydrocele in adult men generally disappear after 6 months. If the hydrocele doesn't go away after this time or it enlarges and causes pain, the doctor will take the following steps:
Hydrocolectomy
This procedure is done by making an incision in the scrotum to drain the fluid inside. Hydrocolectomy is a minor operation, so the patient can go home the same day after surgery.
After undergoing a hydrocelectomy, the doctor will advise the patient to wear a scrotal brace and compress the scrotum with ice cubes to relieve discomfort after surgery.
Aspiration
In addition to a hydrocolectomy, the doctor may also remove fluid in the scrotum through a special needle (aspiration). However, aspiration is only performed in hydrocele patients who have heart problems, are taking blood-thinning medications, or are at risk for complications of hydrocolectomy.
Complications of Hydrocele
Hydroceles are usually harmless and do not affect the fertility of the sufferer. However, in some cases, a hydrocele can signal a serious condition, such as:
- Infections or tumors that affect sperm production or function
- Inguinal hernia, which is the trapping of part of the intestine in the abdominal wall
Hydrocele Prevention
Hydrocele in infants due to fetal developmental abnormalities cannot be prevented. However, in adult men, hydrocele can be avoided. Steps that can be taken include:
- Preventing elephantiasis (filariasis) by avoiding traveling to places experiencing filariasis outbreaks and maintaining personal and environmental hygiene
- Avoid activities that cause scrotal injury
- Wearing special protection in the groin area when doing sports that involve impact