Hydrocele of the testis

A hydrocele can be either congenital or acquired. In newborns, it is often the result of an incompletely closed inguinal canal, through which fluid flows from the abdominal cavity into the scrotum. In adults, the causes can be varied:

• Injuries or inflammations of the testicle or epididymis: Trauma or infections, such as epididymitis, can lead to a buildup of fluid.
• Chronic diseases: Conditions such as heart failure or liver cirrhosis can promote fluid accumulation in the body, including in the scrotum.
• Postoperative complications: A hydrocele can occur after surgery in the genital or inguinal area.

• Swelling of the scrotum, which often develops painlessly
• Feeling of tension in the scrotum
• In some cases, an increase in swelling over the course of the day
• In large hydroceles, the weight of the scrotum can lead to discomfort or pain

The diagnosis is usually made through a physical examination. The doctor may palpate the scrotum and perform a so-called diaphanoscopy, where a light source is held against the scrotum to detect the fluid accumulation. Additionally, an ultrasound can be used to differentiate the hydrocele from other possible causes of swelling, such as tumors or hernias.

• Observation: In many cases, especially in newborns, the hydrocele resolves on its own and does not require treatment. Regular check-ups may, however, be necessary.
• Surgical removal: If the hydrocele causes discomfort in adults or does not resolve on its own, surgery (hydrocelectomy) can be performed, where the fluid is drained and the cavity is sealed.
• Aspiration: In rare cases, the fluid can be removed with a needle, although this is usually only a temporary solution, as the hydrocele often recurs.

There are no specific measures for the prevention of a hydrocele, as it is often congenital or caused by injuries. To reduce the risk of a hydrocele, it is important to avoid injuries in the genital area and to treat inflammations or infections quickly.