Hydrocele is a pathology that consists in the accumulation of fluid in the scrotal sac. It can be unilateral or bilateral.
Types of hydrocele
There are two types of hydrocele: non-communicating or “adult-type” hydrocele and communicating hydrocele.
- Non-communicating hydrocele: it usually manifests itself during adolescence, due to an excess or lack of fluid production from the sheaths surrounding the testicle.
- Communicating hydrocele: it is the most frequent in children. It is usually evident in the first months of the baby. It tends to resolve spontaneously with time. If at an age of around 18 months it has not resolved, it is necessary to intervene.
The communicating hydrocele is produced by a persistence of the vaginal peritoneal duct. This duct closes spontaneously in the fetal period; if this does not occur, the hydrocele appears. If the communication is large, in addition to the passage of fluid, an intestinal loop can slip through, which is called inguinal hernia.
The communicating hydrocele does not normally produce symptoms other than an increase in scrotal volume, which is usually fluctuating, varying throughout the day depending on the activity of the child, its position, etc… It does not usually cause pain or discomfort.
What are the symptoms?
Normally, it translates into an increase in scrotal size and it is usual the sign of transillumination, projection of a light through the scrotum to verify its interior. With this procedure it is possible to appreciate the existence of liquid in the interior. Sometimes the rounded and opaque structure of the testicle can be seen displaced towards one of the walls.
Physical examination is usually sufficient to diagnose it.
Testicular ultrasound is reserved for cases where there is some doubt in the diagnosis. Especially when there is a possibility of inguinal hernia.
What is the treatment? At what age should they be treated?
Treatment of hydrocele is not urgent. Surgical repair will only be considered at the time of diagnosis in those cases where an associated hernia is suspected or diagnosed.
During the first year of age children will be checked periodically by their pediatrician. In most cases hydroceles will disappear spontaneously.
After the age of one year, a pediatric surgeon will evaluate the case and decide on surgical treatment. It is usually performed between 18 and 24 months of age.