It can be easy to overlook subtle changes in our bodies, especially when they don’t cause pain or discomfort.

But when it comes to conditions like hydrocele, a buildup of fluid around the testicles even small signs can tell us something important.

Hydroceles are often harmless and may resolve on their own, but they can also point to underlying issues that need addressing.

Understanding the common signs and symptoms of hydrocele can help you recognize when a visit to the doctor is necessary.

In this blog, Mykare Health will explore what hydrocele is, the key symptoms you shouldn’t ignore, and why early awareness is crucial.

Understanding Hydrocele

A hydrocele is a swelling in the scrotum that occurs when fluid builds up in the thin sheath surrounding a testicle. The term “hydrocele” originates from Greek, where "hydro" means water, and "cele" means swelling.

Hydroceles are most common in newborns, although they can develop in males of any age, especially in older men.

While most hydroceles are not a cause for alarm, they can sometimes be associated with other medical issues, such as infections, injuries, or even tumors. This is why it is crucial to understand the signs and symptoms of a hydrocele and know when to consult a doctor.

Causes of Hydrocele

Hydroceles can develop for several reasons, and the causes can differ based on age groups

• Congenital Hydrocele: In newborns, hydroceles often develop when the processus vaginalis (a sac that descends with the testicles) doesn’t close properly. This leaves a space where fluid can accumulate. Most congenital hydroceles resolve on their own within the first year of life.

• Acquired Hydrocele: In adults, hydroceles can result from injury, inflammation, or infection in the scrotum. Conditions like epididymitis (inflammation of the epididymis) or orchitis (inflammation of the testicle) can contribute to fluid buildup.

• Idiopathic Hydrocele: Often, the cause of a hydrocele is unknown, and it appears without any clear reason. These hydroceles are called idiopathic hydroceles.

• Secondary Hydrocele: Some hydroceles are linked to underlying conditions such as infections, tumors, or injuries. In these cases, treating the root cause often helps in reducing or eliminating the hydrocele.

Common Signs and Symptoms of Hydrocele

Although hydroceles are usually painless, they can cause noticeable symptoms, especially if the fluid buildup increases. Here are some of the common signs and symptoms of a hydrocele

1. Visible Swelling in the Scrotum

One of the most common signs of a hydrocele is a visible swelling in the scrotum, usually on one side, although it can occur on both sides in rare cases. The swelling may fluctuate throughout the day, appearing larger at certain times and smaller at others. The scrotum may look enlarged and feel soft or squishy due to the fluid buildup.

2. Feeling of Heaviness

Men with hydroceles often report a sensation of heaviness or fullness in the scrotum. This can cause discomfort, particularly when moving, walking, or standing for extended periods. Although the feeling is generally not painful, the sensation of heaviness can be bothersome and may interfere with day-to-day activities.

3. Mild Discomfort or Aching

While hydroceles are typically painless, some men experience mild discomfort or aching in the affected testicle. This ache is usually dull rather than sharp and may come and go. Prolonged sitting or physical activities like running or lifting heavy objects can sometimes worsen the aching sensation.

4. Difficulty Sitting or Moving Freely

As the hydrocele grows, it can make sitting or bending over uncomfortable. The enlarged scrotum may press against the thighs or cause irritation, making certain movements awkward or painful. Some men report difficulty moving freely or adjusting their posture due to the size of the hydrocele.

5. Transillumination (Light Passing Through the Swelling)

One of the unique characteristics of a hydrocele is that it usually allows light to pass through it. During a physical examination, a doctor may use a light to shine through the swollen area, a process known as transillumination.

If the swelling is a hydrocele, the light will pass through the fluid, appearing as a soft glow. This method helps differentiate a hydrocele from other scrotal masses, such as tumors or hernias, which block the light.

6. Changes in Size

Hydroceles may change in size over time. For example, they may become smaller after a night’s sleep or when lying down and grow larger when standing or engaging in physical activities. The fluctuation in size can be due to the movement of fluid or the position of the body.

7. Warmth in the Affected Area

In some cases, men with hydroceles experience a sensation of warmth in the swollen area. While this isn’t always a symptom, it may indicate irritation or minor inflammation in the scrotum. If the warmth is accompanied by redness or tenderness, it could signal an infection and warrants immediate medical attention.

When to See a Doctor

Hydroceles are often harmless, but certain symptoms may indicate that it’s time to consult a healthcare professional. Seek medical advice if you experience any of the following

• Sudden or severe pain in the scrotum, which could indicate an underlying issue like testicular torsion or an infection.

• Redness, warmth, or tenderness, which may suggest an infection or inflammation.

• Fever or other signs of infection, as this could indicate epididymitis, orchitis, or another condition affecting the reproductive organs.

• A rapidly increasing size of the hydrocele, which may point to a more serious underlying condition. Prompt medical attention can help determine whether the hydrocele requires treatment or if it is associated with another condition.

Diagnosing Hydrocele

If you suspect you have a hydrocele, a doctor can conduct a simple examination to confirm the diagnosis. Here are the primary methods used to diagnose hydroceles

• Physical Examination: The doctor will examine the scrotum, checking for swelling, tenderness, and changes in texture.

• Transillumination Test: As mentioned earlier, transillumination helps distinguish a hydrocele from other types of swelling or masses by showing if light passes through the fluid-filled area.

• Ultrasound Imaging: An ultrasound is often used for a more detailed view of the scrotum, particularly if the doctor suspects another condition, such as a hernia or tumor. This painless imaging test provides a clear picture of the scrotal structures, helping to rule out other causes of swelling.

Treatment Options for Hydrocele

In many cases, hydroceles resolve on their own, especially in infants. However, when symptoms persist or cause discomfort, there are treatment options available

• Watchful Waiting: If the hydrocele is small and not causing any discomfort, a doctor may recommend observation, as many hydroceles resolve without intervention.

• Aspiration: In some cases, the fluid can be drained using a needle, although this approach is usually temporary as fluid often reaccumulates. Aspiration is typically reserved for those who cannot undergo surgery.

• Surgical Repair (Hydrocelectomy): A hydrocelectomy is a procedure to remove the hydrocele. It involves making a small incision in the scrotum to drain the fluid and close off the sac. This is generally the most effective solution, with low chances of recurrence.

• Laparoscopic Surgery: For hydroceles caused by underlying issues, laparoscopic surgery may be used to address both the hydrocele and its root cause. This minimally invasive approach is beneficial in reducing recovery time.

Risks and Complications Associated with Hydrocele

Although hydroceles are usually harmless, there can be complications if left untreated

• Infections: Untreated hydroceles may lead to infections, especially if associated with an underlying inflammatory condition.

• Pain and Discomfort: Larger hydroceles can cause persistent discomfort, restricting mobility and everyday activities.

• Pressure on Testicles: A large hydrocele may exert pressure on the testicles, which can impact testicular function and blood flow in severe cases.