A hydrocele is a form of swelling in the scrotum whereby fluid collects in the thin sheath that surrounds a testicle. While this is common in babies, it is something that older boys and men can develop following inflammation and injury within the scrotum. While they are not painful and may not require treatment, it is always advised that you seek specialist advice.

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Hydroceles are rarely painful, but adults could experience some discomfort if their swollen scrotum is heavy.

The hydrocele might become painful as it gets bigger and inflammation increases. You might find the swollen area gets larger throughout the day. 

A hydrocele doesn’t affect your fertility and is unlikely to harm you. But it’s sometimes a sign of an underlying condition that can cause severe problems. 

One problem is infections and tumors that affect sperm production and quality.

Another is an inguinal hernia, where part of your intestine gets trapped in the abdominal tissues. Hernias can lead to life-threatening complications.


To diagnose the problem a specialist will need to carry out a physical examination where they will check for tenderness in the enlarged scrotum. They will also check the abdomen and scrotum to check whether there is an inguinal hernia while shining a light through the scrotum will enable them to check that there is clear fluid surrounding the testicle. After a physical examination, a specialist might suggest blood and urine tests to rule out infection while an ultrasound will help to rule out a hernia, tumour or other causes of scrotal swelling.


There are two: communicating hydrocele and non-communicating hydrocele.

  • Communicating hydrocele: This is a type of hydrocele that has contact (communication) with the fluids of the abdominal cavity. A communicating hydrocele is caused by the failure of the processus vaginalis (the thin membrane that extends through the inguinal canal and extends into the scrotum). If this membrane remains open, there is a potential for both a hernia and a hydrocele to develop. The child’s scrotum will appear swollen or large and may change in size throughout the day.
  • Non-communicating hydrocele: In this type, the inguinal canal did close, but there is still extra fluid around the testicle in the scrotum. This condition might be present at birth or might develop years later for no obvious reason. A non-communicating hydrocele usually remains the same size or has very slow growth.


Surgery may be required to remove the hydrocele. Often, this is carried out as a daycase procedure and a hyrdocelectomy is carried out under either general or regional anaesthesia. The surgeon will make an incision in the scrotum and then remove the hydrocele.

After surgery, in most cases, the patient can return home the same day. However, in some instances, a tube might be required to drain the fluid while a dressing will need to be worn for a few days. Your specialist is then likely to request a follow-up examination to ensure that everything has healed but to also make sure that it has not recurred.

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