Hydrocoele

An hydrocoele is a collection of fluid that surrounds the testicle.

In the majority of cases it is caused by fluid from the abdomen that has become trapped in a space that surrounds the testicle. Occasionally, it may occur after infection or inflammation of the testicle or epididymis and it may occur following a twist of a part of the testicle or epididymis. An hydrocoele may also develop after a trauma to the testicle and very occasionally may occur in the presence of a testicular cancer.

Over 50% of baby boys are born with some degree of hydrocele. It occurs more commonly on the right side. In 10-20% of cases, it occurs on both sides.

It almost exclusively occurs in boys, however, it can occur in girls who have a small out-pouching of the lining of the abdomen.

When does this need referral to a paediatric surgeon?

An hydrocoele usually presents at birth with a soft painless swelling in the scrotum. It does not cause any distress to the babies, however, if they are distressed or crying for other reasons, it may become more obvious.

Any child that has a swelling in the scrotum should be reviewed by a Paediatric Surgeon. The diagnosis of an hydrocoele is made without the use of any tests, however, an ultrasound may occasionally be used to confirm the diagnosis.

When to operate?

In over 90% of boys who are born with an hydrocoele, the hydrocoele will resolve of its own accord within the first 12-18 months of life. If the hydrocoele persists, there may be a small persisting communication with the abdomen, allowing the hydrocoele to fill with the fluid that bathes the guts. If an hydrocele is still present at 18 months of age, it is unlikely that it will then resolve and an operative repair should be recommended. The repair is usually performed before the child starts Nursery School. Even though it is unlikely that the hydrocoele will cause any problems, all little boys prefer to be the same as their friends and do not want to be teased if they have a noticeable swelling in their scrotum.

Following the repair of the hydrocoele, the prognosis is excellent and the chances of recurrence are slight.