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Hydrocele in Children

Summary

A hydrocele is a painless collection of fluid around the testicle, causing swelling in the scrotum. It is common in newborn boys and usually resolves on its own within the first year of life. In rare cases, a similar condition can occur in females along the canal of Nuck.

There are two types of hydroceles:

  • Communicating hydrocele: A small opening between the abdomen and scrotum allows fluid to move in and out, sometimes causing the swelling to change in size.

Non-communicating hydrocele: The fluid is trapped in the scrotum without connection to the abdomen, typically resolving without treatment

Diagnosis and When to Seek Help

Parents should consult a doctor if their child has:

  • A painless swelling in one or both sides of the scrotum
  • A scrotum that appears larger at different times of the day (suggesting a communicating hydrocele)
  • Persistent swelling beyond 12–18 months of age

Doctors can usually diagnose a hydrocele with a physical exam. In some cases, transillumination (shining a light through the scrotum) or an ultrasound may be used to confirm the diagnosis and rule out other conditions.

Management

  • Observation: Most hydroceles in infants resolve on their own by 12 to 18 months without any treatment.
  • Surgery: If the hydrocele persists beyond 18 months, causes discomfort, or is associated with an inguinal hernia, a surgical procedure called hydrocelectomy may be needed. This is a minor outpatient procedure.

Follow-Up and Monitoring

After diagnosis, regular follow-ups may be recommended to monitor the hydrocele. If surgery is required, children typically recover quickly with minimal discomfort.

If you notice persistent or changing swelling in your child’s scrotum, consult a doctor to determine the best course of action.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Scrotal mass
  • Transillumination
  • Enlargement of scrotal mass following activity

Risk factors

  • Male sex
  • Prematurity and low birth weight
  • Infants <6 months of age
  • Infants whose testes descend relatively late

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Ultrasound

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    Other Related Conditions

    urinary tract infections

    continence & bedwetting

    phimosis / circumcision

    malformation of the kidney

    penile abnormalities (hypospadias, epispadias)

    disorders of sexual development

    scrotal issues (undescended testis, hernias)

    hydronephrosis

    vesico-ureteral junction obstruction

    vesico-ureteral reflux

    stones (kidney, ureter, bladder)

    tumors (kidney, testis)

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS