Hydrocele: Symptoms, Causes, Treatment
القيلة المائية
A hydrocele is fluid around a testicle causing scrotal swelling, often without pain. New swelling needs assessment; sudden severe pain is an emergency and should not automatically be attributed to a hydrocele.
What is Hydrocele?
Infant hydroceles differ from those developing later. A hydrocele communicating with the abdomen may change size through the day and coexist with a hernia. Size alone does not identify the type.
Related reading: Testicular lumps and cancer assessment.
Symptoms
Typical swelling affects one or both sides without pain; adults may notice heaviness. Redness, fever, severe pain or rapid change warrants assessment for another cause or a complication.
Causes
A passage between abdomen and scrotum may remain open after birth, or fluid may become trapped around the testicle. Later cases can follow injury, inflammation or another cause requiring examination.
Risk factors
Congenital hydroceles occur in infants, particularly those born prematurely. In adults, injury, infection and other causes are considered; swelling should not simply be attributed to age.
Diagnosis
Assessment checks the testicles and for a hernia, sometimes using transillumination and ultrasound. Examination helps identify a testicular problem that fluid could otherwise conceal.
Treatment
Some noncommunicating infant hydroceles can be observed because they may resolve. Communicating hydroceles or associated hernias need pediatric surgical assessment. Adult treatment depends on cause, size and symptoms. Never attempt home needle drainage.
Complications
The fluid collection itself is often harmless, but hernia, infection or testicular disease may coexist. Recurrence is possible after treatment; discuss the benefits and risks of surgery beforehand.
Prevention
Not all congenital hydroceles can be prevented. Protecting against scrotal injury and treating diagnosed infection may help, but antibiotics do not treat every hydrocele.
When to see a doctor
Sudden severe testicular pain or rapid swelling with nausea needs emergency evaluation to exclude torsion. Arrange an examination for new or persistent swelling even if painless.