What is a testicular hydrocele?
If you suffer from a hydrocele, this is usually indicated by a swollen testicle on one side. The swelling can vary in severity depending on where the hernia forms and how much fluid accumulates.
A hydrocele of the testicle can be congenital. One to seven percent of boys are born with it. This primary hydrocele occurs unilaterally or bilaterally and usually disappears without treatment in the first few months of life. More often a hydrocele develops secondarily in the course of your life, usually caused by inflammation.
A hydrocele usually causes hardly any symptoms. However, if your testicles swell considerably, you may feel pain, a feeling of pressure or heaviness. In some cases, the testicular hernia resolves on its own and treatment is then not necessary. However, if the swelling is very large and interferes with everyday life, it may be necessary to operate on it.
Hydrocele of the testicle: causes and risk factors
The hydrocele of the testicle can be congenital (primary) or acquired (secondary).
Primary hydrocele
Congenital hydrocele develops as follows:
- The testicles mature in your abdominal cavity and then descend into the scrotum shortly before or after birth or in the first few years of life.
- They take part of the peritoneum with them into the scrotum.
- This part of the peritoneum then forms a small gap, which usually closes to the peritoneum before birth, sometimes only towards the first year of life.
- If this seal does not form or only forms inadequately, fluid can accumulate in the cleft space and lead to swelling of the scrotum.
- If the cleft remains open, the affected boy can also suffer a hernia.
Secondary hydrocele
Hydrocele due to acquired causes, the so-called secondary hydrocele, affects adults or older children. The possible causes of this are, for example
- inflammation of the testicles or epididymis
- Consequences of surgery (e.g. to remove a varicose vein in the testicles)
- Injuries or violence
- Very rare testicular tumors
The cause of water retention as a result of a secondary hydrocele is that the body either produces too much testicular sheath fluid or absorbs too little.
Symptoms: Accumulation of fluid in the scrotum
A typical symptom of a testicular hernia (lat. = testis) is the unilateral or sometimes bilateral swelling of the scrotum. As a rule, it develops slowly and is not painful. It does not cause any symptoms in the early stages. It becomes very large,
- you feel pressure and heaviness,
- pain may occur,
- the swelling restricts your mobility, e.g. when walking.
An acute hydrocele can occur as a special form: This is typically characterized by acute swelling with a sudden onset of severe pain.
If the hydrocele is already present in a newborn baby, it usually disappears on its own. However, it is not uncommon for the little boy to suffer a hernia in connection with this. This in turn can cause complications, for example because it pinches off the intestines. In severe cases, a quick operation is then necessary.
Diagnosis with us
If a rupture of the testicles is suspected, we will first ask a few questions. Among other things, we will want to know,
- when you first noticed the swelling of the testicles,
- whether it changes when standing or lying down,
- whether violence was used against the testicles.
We will then palpate the scrotum and testicles to find out how swollen they are and whether any hardening can be felt.
To confirm the diagnosis, we usually then perform an examination using an imaging procedure, such as an ultrasound scan (sonography), which makes a fluid accumulation visible.
Hydrocele of the testicle: prevention, early detection, prognosis
Around ten percent of male babies are born with a primary hydrocele. It is not possible to prevent it. We usually recognize these immediately during the first medical examinations.
You can prevent a secondary hydrocele in adolescence or adulthood by having possible triggers such as testicular inflammation or epididymitis treated consistently. Take advantage of screening tests for testicular cancer with your urologist. Also protect yourself from injuries and violence in the genital area.
Prognosis of the hydrocele
The hydrocele of the testicle is benign and has a positive prognosis. In most cases, the primary (congenital) form regresses on its own without treatment. In the case of the secondary (acquired) form, it is usually sufficient to treat the actual cause.
If the symptoms persist for a longer period of time, surgery can help. She also has a good prognosis. Sometimes the hydrocele reappears afterwards.
Hydrocele of the testicle: treatment of the cause
The treatment of a testicular hernia depends on whether it is a primary or secondary form and what caused it.