Hydrocele

A hydrocele is a condition when fluid accumulates around the testicles. The accumulation of this fluid can cause swelling and pain in the scrotum.

The testicles are part of the male reproductive system. This organ functions to produce sperm and the hormone testosterone. A pair of testicles is in the scrotal pouch and hangs just below the base of the penis.

Normally, the scrotum will be palpable, soft, and firm but not hard. However, in hydrocele sufferers, the scrotum will feel soft like a balloon filled with water. Hydrocele is usually experienced by newborn boys, but it can also occur in adult men.

Although generally harmless, hydrocele sufferers still need to see a doctor. The purpose is to find out if the hydrocele is not caused by a serious disease, such as testicular cancer .

Types of Hydrocele

In general, hydrocele is divided into two types, namely:

• Noncommunicating hydrocele
  Noncommunicating hydrocele occurs when the gap between the abdominal cavity and the scrotum (inguinal canal) closes, but the fluid in the scrotum is not absorbed by the body.

• Communicating
  hydrocele Communicating hydrocele occurs when the inguinal canal does not close so that fluid from the abdominal cavity continues to flow into the scrotum and can rise back into the abdomen. Communicating hydrocele can be accompanied by inguinal hernia .

Causes of Hydrocele

Hydrocele in infants and adult men is caused by different conditions. Here is the explanation:

Hydrocele in babies

In babies, hydrocele occurs as a result of developmental abnormalities while still in the womb. This disorder causes the accumulation of fluid in the scrotum.

During development, the two fetal testicles that are initially in the abdomen will descend into the scrotum through the gap between the abdominal cavity and the scrotum. The two testicles descend into the scrotum along with fluid.

If it develops normally, this gap called the inguinal canal will close during the first year of the baby's birth. The liquid in the scrotum will also be gradually absorbed into the baby's body.

However, in babies with hydrocele, the process does not run normally so the inguinal canal does not close. As a result, the scrotum remains filled with fluid and swells.

Hydrocele in adult men

Hydrocele can also occur in adult men. This condition is generally caused by a number of conditions, such as:

• Inguinal hernia operation
• Injury or impact to the scrotum
• Elephant foot disease ( filariasis )
• Inflammation of the sperm ducts ( epididymitis )
• Testicular tumor

Risk factors for hydrocele

Premature babies are more at risk of developing hydrocele. While in adult men, the risk of hydrocele can increase if they have the following conditions:

• Suffering from sexually transmitted diseases
• Having an injury or inflammation of the scrotum

Symptoms of Hydrocele

Hydrocele in babies is characterized by swelling on one or both sides of the scrotum. If palpated, the scrotum will feel soft like a balloon filled with water. This swelling is usually not accompanied by pain and will deflate on its own.

While in adult men, symptoms of hydrocele can be swelling in the scrotum. In addition, a swollen hydrocele will feel uncomfortable or heavy. Sometimes, the swelling of the scrotum will be more clearly visible in the morning.

When should you go to the doctor?

Check with a doctor if you or your child experiences any of the above complaints. Medical help should also be given immediately if the following conditions exist:

• The scrotum swells suddenly and quickly
• Severe pain that appears suddenly in the scrotum even though it is not swollen
• Pain or swelling in the scrotum appears several hours after the injury
• Hydrocele in babies does not disappear at the age of 1 year

Diagnosis of Hydrocele

To diagnose a hydrocele, the doctor will ask questions about the symptoms experienced and the patient's health history. Next, the doctor will perform a physical examination of the scrotum to confirm the diagnosis. The physical examination can be in the form of:

• Pressing on the swollen scrotum, to find out the degree of hardness
• Pressing the abdomen and scrotum, to detect the possibility of inguinal hernia symptoms
• Shining light on the testicles with a light that penetrates into the scrotum ( transillumination ), to see the accumulation of fluid in the scrotum

If the swelling of the scrotum is suspected to be caused by an infection, the doctor will perform a urine test and a blood test to confirm the diagnosis. However, if the swollen scrotum is suspected to be caused by a hernia or a testicular tumor, the doctor will perform an ultrasound on the testicles.

Hydrocele Treatment

Hydrocele in babies will usually disappear by itself after the baby is 1 year old. While in adult men, hydrocele generally disappears after 6 months.

If the hydrocele does not disappear after that period of time or grows larger and causes pain, the doctor can perform treatment actions, including:

Hydrocolectomy

In this procedure, the doctor will make an incision in the scrotum to remove the fluid inside. Hydrocolectomy is classified as a minor operation so the patient can go home the same day after the operation.

After hydrocelectomy, the doctor will advise the patient to use a scrotal support and give a cold compress to the scrotum to ease the discomfort after the operation.

Aspiration

The doctor can also remove the fluid in the scrotum through a special needle (aspiration). However, aspiration is only performed in patients who suffer from heart disorders, are taking blood thinners, or are at risk of experiencing hydrocolectomy complications.

Complications of Hydrocele

Hydrocele is usually harmless and does not affect the sufferer's fertility. However, in some cases, hydrocele can cause serious complications, such as:

• Infections or tumors that affect sperm production or function
• Inguinal hernia, which is the protrusion of part of the intestine inside the abdominal wall

Inguinal hernia generally occurs in the communicating hydrocele type. This condition occurs as a result of a gap between the abdominal cavity and the scrotum which creates pressure so that the intestine is pushed into the hole and forms a bulge.

Hydrocele Prevention

Hydrocele in babies due to developmental abnormalities cannot be prevented. However, in adult men, hydrocele can be prevented in several ways, namely:

• Preventing elephantiasis (filariasis) by avoiding traveling to places with filariasis outbreaks, as well as maintaining personal and environmental hygiene
• Avoid activities that cause injury to the scrotum
• Wear special protection in the groin area when doing sports that can put pressure on the groin area, such as cycling or horse riding