What is a hydrocoele?
A hydrocoele is an accumulation of fluid around a testicle on one or both sides.
How is it caused?
A hydrocoele results when fluid accumulates between the two layers covering the testes. Most often there is no cause found. Hydrocoeles can also develop as a result of injury or infection. It may sometimes accompany other problems such as chronic infections or the presence of a tumour in the testicle.
What are the symptoms?
An enlarged scrotum on one or both sides.
A bulging area within the groin.
The condition is usually painless, although sometimes it may cause a dragging sensation or mild pain.
How is the condition diagnosed?
Physical examination by the doctor reveals a non-tender mass within the two layers of the sac around the testes. The fluid in a hydrocoele is clear. A bright light from a torch shone through the scrotum indicates the presence of clear fluid (a process called transillumination). An ultrasound may be done to confirm the diagnosis.
What is the treatment?
Surgical treatment is recommended if:
A hydrocoele that was present at birth remains after the child has reached the age of one year.
It causes pain and discomfort due to its size and is not resolving.
Swelling increases and decreases (suggesting that the opening is big enough to allow fluid to flow freely back and forth between the area of the hydrocoele and the abdominal cavity.
In adults, a hydrocoele can be treated by a process called needle aspiration (a thin needle is used to withdraw the fluid). After this, the chance of recurrence of a hydrocoele is quite high. Another aspiration technique involves removing the fluid and then injecting thickening or hardening medications such as tetracycline, sodium tetradecyl sulphate, or urea to close off the lining of the scrotal sac and prevent reaccumulation of the fluid.
Surgery (Hydrocoelectomy) is the most common form of treatment. This procedure is done under general or spinal anaesthesia. There can be possible complications of surgery which include haematoma (blood clot formation), abscess or injury to the scrotal tissues. Hydrocoelectomy does not however affect sperm or hormone production of the testicles.