Hydrocele is swelling in the scrotum due to a build-up of fluid around the testicle(s). It occurs in two forms:
A varicocele is swelling in the scrotum due to a back up of blood in the main veins of the scrotum. Varicoceles are most common among teenagers and adult men.
Not all hydrocele or varicoceles require treatment. However, it is important to see your doctor for a diagnosis if you or your baby boy develops a swelling in the scrotum.
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A communicating hydrocele occurs in babies when a channel that connects the scrotum to the abdomen does not close up properly. This allows fluid to leak into the scrotum.
Non-communicating hydroceles occur when fluid builds up within the tissues that surround the testicle. Hydroceles may also be caused by injury or infection in the scrotal area. It can also be caused by a testicular tumor.
A varicocele is caused by a problem in the main vein of the scrotum. Blood normally leaves the scrotum through the vein. When this vein is not working properly, the blood gets backed up into the scrotum. Varicoceles are rarely caused by kidney tumors, or other tumors in the location of the kidney.
Many newborn boys will develop a hydrocele. Communicating hydroceles are more common in premature babies. They are also more common in children who are being treated for excess fluid in the brain or who have an abdominal dialysis catheter.
Varicoceles typically develop in men between the ages of 15-25.
If you have any of these symptoms, do not assume it is due to hydrocele or varicocele. These symptoms may be caused by other, sometimes serious, health conditions. If you experience any one of them, see your doctor:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Hydroceles and varicoceles are usually easily diagnosed by exam. Your doctor will want to be sure there is no evidence of a testicular tumor. Tests may include the following:
Treatment options include the following:
In infants, non-communicating hydroceles often resolve in the first year of life without treatment.
Surgical repair is recommended if:
Sclerotherapy may be used for adult non-communicating hydroceles. This procedure removes fluid through a needle and replaces it with a substance that causes scarring. This is generally less effective than surgery.
Treatment is not required for all varicoceles. However, varicoceles can increase the risk of infertility. Treatment is generally recommended if a varicocele is causing infertility or if it occurs in adolescents. Treatment options include:
If you are diagnosed with a varicocele or hydrocele, follow your doctor's recommendations.
American Society for Reproductive Medicine
American Urological Association
The College of Family Physicians of Canada
Hydrocele. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated April 2, 2012. Accessed September 14, 2012.
The Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. American Society of Reproductive Medicine website. Available at: http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Joint_Reports/Report_on_varicocele(1).pdf. Published 2001. Accessed September 14, 2012.
Varicocele. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 23, 2011. Accessed September 14, 2012.
Varicocele. American Society for Reproductive Medicine website. Available at: http://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/Varicocele.pdf. Accessed September 14, 2012.
Wein A, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Last reviewed September 2012 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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