- Home
- Search
- Tools
- CME
- Help & Feedback
- About epocrates
- Business Solutions
Highlights & Basics
- A hydrocele is a collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck.
- Common in male infants and the newborn. Most pediatric hydroceles are congenital and, in the majority of cases, resolve within the first year of life.
- May occur in adult men where they are found secondary to minor trauma, infection, testicular torsion, epididymitis, varicocele operation, or testicular tumor.
- The main symptom is a painless, swollen scrotum on 1 or both sides, which feels like a water-filled balloon.
- Treatment depends on the age of the patient and the degree of discomfort caused by the hydrocele. Surgery will only be performed if the hydrocele is causing problems or there is evidence of underlying pathology.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Dagur G, Gandhi J, Suh Y, et al. Classifying hydroceles of the pelvis and groin: an overview of etiology, secondary complications, evaluation, and management. Curr Urol. 2017 Apr;10(1):1-14.[Abstract][Full Text]
European Association of Urology. EAU guidelines on paediatric urology. Mar 2023 [internet publication].[Full Text]
1. Rafailidis V, Varelas S, Apostolopoulou F, et al. Nonobliteration of the processus vaginalis. Sonography of related abnormalities in children. J Ultrasound Med. 2016 Apr;35(4):805-18.[Abstract]
2. Dagur G, Gandhi J, Suh Y, et al. Classifying hydroceles of the pelvis and groin: an overview of etiology, secondary complications, evaluation, and management. Curr Urol. 2017 Apr;10(1):1-14.[Abstract][Full Text]
3. Karbasian N, Segaran N, Solomon N, et al. Pathologic conditions at imaging of the spermatic cord. Radiographics. 2022 May-Jun;42(3):741-58.[Abstract][Full Text]
4. Kaefer M, Agarwal D, Misseri R, et al. Treatment of contralateral hydrocele in neonatal testicular torsion: is less more? J Pediatr Urol. 2016 Oct;12(5):306.e1-306.e4.[Abstract]
5. Kapur P, Caty MG, Glick PL. Pediatric hernias and hydroceles. Pediatr Clin North Am. 1998 Aug;45(4):773-89.[Abstract]
6. Baskin LS, Kogan BA. Hydrocele/hernia. In: Gonzales ET, Bauer SB, eds. Pediatric urology practice. Philadelphia, PA: Lippincott, Williams & Wilkins; 1999:649-53.
7. Skoog SJ. Benign and malignant pediatric scrotal masses. Urol Clin North Am. 1997 Oct;44(5):1229-50. [Abstract]
8. Barthold JS, Kass EJ. Abnormalities of the penis and scrotum. In: Belman AB, King LR, Kramer SA, eds. Guide to clinical pediatric urology. London: Martin Dunitz; 2002:267-98.
9. Rowe MI, Copelson LW, Clatworthy HW. The patent processus vaginalis and the inguinal hernia. J Pediatr Surg. 1969 Feb;4(1):102-7.[Abstract]
10. Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children - a study of 1,000 cases and a review of the literature. J Am Med Womens Assoc. 1972 Oct;27(10):522-5.[Abstract]
11. Schneck FX, Bellinger MF. Abnormalities of testis and scrotum and their surgical management. In: Wein AJ, Kavoussi LR, Novick AC, et al, eds. Campbell-Walsh urology. 9th ed. Philadelphia, PA: WB Saunders; 2007:3761-98.
12. Small CM, DeCaro JJ, Terrell ML, et al. Maternal exposure to a brominated flame retardant and genitourinary conditions in male offspring. Environ Health Perspect. 2009 Jul;117(7):1175-9.[Abstract][Full Text]
13. Metcalfe PD, Farivar-Mohseni H, Farhat W, et al. Pediatric testicular tumors: contemporary incidence and efficacy of testicular preserving surgery. J Urol. 2003 Dec;170(6 pt 1):2412-5; discussion 2415-6.[Abstract]
14. Ahmed HU, Arya M, Muneer A, et al. Testicular and paratesticular tumours in the prepubertal population. Lancet Oncol. 2010 May;11(5):476-83.[Abstract]
15. Al-Kandari AM, Shabaan H, Ibrahim HM, et al. Comparison of outcomes of different varicocelectomy techniques: open inguinal, laparoscopic, and subinguinal microscopic varicocelectomy: a randomized clinical trial. Urology. 2007 Mar;69(3):417-20.[Abstract]
16. Esposito C, Valla JS, Najmaldin A, et al. Incidence and management of hydrocele following varicocele surgery in children. J Urol. 2004 Mar;171(3):1271-3.[Abstract]
17. Lipshultz LI, Thomas AJ, Khera M. Surgical management of male infertility. In: Wein AJ, Kavoussi LR, Novick AC, et al, eds. Campbell-Walsh urology. 9th ed. Philadelphia, PA: WB Saunders; 2007:665.
18. Streit T, Lafontant JG. Eliminating lymphatic filariasis: a view from the field. Ann N Y Acad Sci. 2008;1136:53-63.[Abstract][Full Text]
19. European Association of Urology. EAU guidelines on paediatric urology. Mar 2023 [internet publication].[Full Text]
20. Cimador M, Castagnetti M, De Grazia E. Management of hydrocele in adolescent patients. Nat Rev Urol. 2010 Jul;7(7):379-85.[Abstract]
21. Brainwood M, Beirne G, Fenech M. Persistence of the processus vaginalis and its related disorders. Australas J Ultrasound Med. 2020 Feb 20;23(1):22-9.[Abstract][Full Text]
22. Chang YT, Lee JY, Wang JY, et al. Hydrocele of the spermatic cord in infants and children: its particular characteristics. Urology. 2010 Jul;76(1):82-6.[Abstract]
23. Busigó JP, Eftekhari F. Encysted spermatic cord hydroceles: a report of three cases in adults and a review of the literature. Acta Radiol. 2007 Dec;48(10):1138-42.[Abstract]
24. Rajput A, Gauderer MW, Hack M. Inguinal hernias in very low birth weight infants: incidence and timing of repair. J Pediatr Surg. 1992 Oct;27(10):1322-4.[Abstract]
25. DeCou JM, Gauderer MW. Inguinal hernia in infants with very low birth weight. Semin Pediatr Surg. 2000 May;9(2):84-7.[Abstract]
26. Kogan BA. Communicating hydrocele/hernia repair in children. BJU Int. 2007 Sep;100(3):703-14.[Abstract]
27. Dogra VS, Gottlieb RH, Oka M, et al. Sonography of the scrotum. Radiology. 2003 Apr;227(1):18-36.[Abstract]
28. American College of Radiology. ACR appropriateness criteria: acute onset of scrotal pain - without trauma, without antecedent mass. 2018 [internet publication].[Full Text]
29. Sandlow JI, Winfield HN, Goldstein M. Surgery of the scrotum and seminal vesicles. In: Wein AJ, Kavoussi LR, Novick AC, et al, eds. Campbell-Walsh urology. 9th ed. Philadelphia, PA: WB Saunders; 2007:1105-6.
30. Altinkilic B, Pilatz A, Weidner W. Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J Urol. 2013 May;189(5):1853-8.[Abstract]
31. International Pediatric Endosurgery Group. IPEG guidelines for inguinal hernia and hydrocele. J Laparoendosc Adv Surg Tech A. 2010 Mar;20(2):x-xiv.[Abstract][Full Text]
32. Abel EJ, Pettus JA, Snow B. Laparoscopic marsupialization before inguinal repair of large abdominoscrotal hydroceles in infants: observation of natural history and description of technique. Urology. 2009 Mar;73(3):507-9.[Abstract]
33. Shakiba B, Heidari K, Afshar K, et al. Aspiration and sclerotherapy versus hydrocelectomy for treating hydroceles: a systematic review and meta-analyses. Surg Endosc. 2023 Jul;37(7):5045-51.[Abstract]
34. Jahnson S, Sandblom D, Holmang S. A randomized trial comparing 2 doses of polidocanol sclerotherapy for hydrocele or spermatocele. J Urol. 2011 Oct;186(4):1319-23.[Abstract]
35. Zampieri N, El-Dalati G, Ottolenghi A, et al. Percutaneous aspiration for hydroceles after varicocelectomy. Urology. 2009 Nov;74(5):1122-4.[Abstract]
36. Mäki-Lohiluoma L, Kilpeläinen TP, Järvinen P, et al. Risk of complications after hydrocele surgery: a retrospective multicenter study in Helsinki metropolitan area. Eur Urol Open Sci. 2022 Jul 19:43:22-7.[Abstract][Full Text]
37. Fallatah M, Aljuhaiman A, Alali H, et al. Infertility secondary to an infected hydrocele: a case report. Urol Case Rep. 2019 Nov 8:28:101071.[Abstract][Full Text]
38. Osegbe DN. Fertility after sclerotherapy for hydrocele. Lancet. 1991 Jan 19;337(8734):172.[Abstract]
