Making sense of hydroceles in men

Making sense of hydroceles in men

A condition in males called a hydrocele is a painless buildup of watery fluid collecting inside the scrotum, surrounding the testicles.  They are usually not considered dangerous or a threat to a man’s health.  Hydroceles are most common in newborn baby boys as about 10 percent will be born with a hydrocele which should resolve within a few months after birth.   Babies born prematurely are more likely to have a hydrocele. Hydroceles can also occur later in life in boys and men.  

Generally, within the scrotum a small amount of lubricating fluid is produced allowing the testicles to move freely.  However, a hydrocele can form when excess fluid that usually drains away into the scrotum’s veins, fail to do so.  This is when the excess fluid will accumulate, forming a hydrocele.

Causes of hydroceles

Generally, the cause of a hydrocele is unknown.  However, in newborns, the reason may be an opening found between the abdomen and the scrotum which normally closes before birth or soon after.

Hydroceles that develop in boys or men, may form from an injury or surgery to the scrotum or groin area, or by inflammation or infection of the epididymis or testicles.  Another uncommon cause is that a hydrocele could form due to cancer of the testicle or left kidney.  

Symptoms of hydroceles

The main symptom is a painless, swollen, or enlarged scrotum or testicle on one or both sides that feels like a water-filled balloon mainly found in front of one of the testicles. Typically the scrotum feels loose, soft, and fleshy.  Other symptoms could include pain, swelling, or redness of the scrotum or a feeling of pressure at the base of the penis.

If a hydrocele becomes large, it may cause discomfort because of the size particularly when a man walks or has sex.  

Diagnosing a hydrocele

Any male of any age who notices a change in the size or feel of his scrotum or testicles needs to have it checked out by his physician as it could be associated with an underlying testicular condition. 

The physician will examine the area, shining a light behind each testicle, known as transillumination.  The physician is checking for solid masses due to other problems such as cancer of the testicle. Light will not pass through a solid tumor mass. But, because hydroceles are filled with fluid, the light will shine right through them. 

An ultrasound can also confirm the diagnosis of a hydrocele.

Treatment for a hydrocele

Since there is little to no health danger from a hydrocele, treatment occurs only if they are causing pain, embarrassment or if the blood supply to the penis is reduced.  If the hydrocele stays the same in size or gets smaller on its own as the body reabsorbs the fluid, then no treatment is necessary.  A hydrocele in men younger than age 65 should go away on their own but in men over 65, they do not.  There are no medications available to treat adult hydrocele, although pain medication may help relives any discomfort. 

Another option is a surgery known as a hydrocelectomy, a possible recommendation if the hydrocele is large, causes pain or has developed an infection.  A large hydrocele can become embarrassing or threaten the normal functioning of the other structures in the scrotum. The surgery, which is typically outpatient, involves making a tiny cut in the scrotum and then draining the fluid from around the testicle.  Sealing off the passage between the abdomen and the scrotum, will prevent a hydrocele from forming again. 

A hydrocele can also be removed by draining the fluid by aspiration or needle.  However, aspirated hydroceles will often come back refilling with fluid within a few months.  If a man is not fit for surgery, he can have them drained now and then.


Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911. 

Making sense of hydroceles in men
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Dr. David B. Samadi