Hydrocele in Children: Diagnosis and Treatment

How do doctors diagnose hydroceles in children?

While most hydroceles get better on their own, it is necessary to see your child’s care team to make sure they do not have other, more serious scrotal conditions, such as a hernia. Though an ultrasound can sometimes help make the diagnosis, usually an in-person physical examination is all that is needed to determine whether a hydrocele or hernia is the cause of swelling.

How are hydroceles treated in children?

Treatment depends on the type of hydrocele your child has and on the amount of fluid in the sac. Most non-communication hydroceles get better on their own by the time your child is 1 year old. If symptoms last longer than a year, it is likely that the hydrocele is communicating and surgery is needed.

If a non-communicating hydrocele does not resolve on its own, or if a communicating hydrocele is present, surgery is needed. Without surgery, the extra fluid keeps the testicle warmer than it should be to develop normally. Some hydroceles are actually hernias. These always need to be fixed with surgery in children.

Surgery is usually scheduled as an outpatient procedure. This allows your child to go home the same day. The surgery is done under general anesthesia. The pediatric surgeon creates a small incision below the belt line and drains the extra fluid. They also remove the hydrocele lining within the scrotum. Then, they close off the tunnel with dissolvable sutures (stitches). The incision is closed with stitches under the skin. Over time, the stitches will dissolve as the incision heals.

What are the possible risks of hydrocele surgery?

After surgery, children usually have very little pain. Over-the-counter pain medication, including acetaminophen (Tylenol®) or ibuprofen (Motrin®), are usually all that they need. After hydrocele surgery, your child can return to normal activities when they feel ready.