Hydrocele

Here are typical symptoms: 

• Bulge in the scrotum
• Lump in the testicle
• Pain or discomfort
• Scrotal or groin swelling

However, if you experience severe pain, pain associated with nausea/vomiting, or an abnormal lie of the testicle this can be a sign of testicular torsion. You should go to the ER immediately.

Most of the time there is no identifiable or underlying cause, but a hydrocele can occur after testicular injury or after hernia surgery.

During your visit your doctor will ask you questions regarding your medical history, surgical history, medications and will perform an exam with focused attention to the groin and genitalia.

Tests that may be performed during or after your visit:

• Urinalysis: This test evaluates for any blood in the urine or infection.
• Scrotal ultrasound: This is an imaging study that looks at the testicles, epididymis, hydrocele sac and assesses blood flow to and from the testicle.
• Light: Your physician may place a strong light behind the testicle to see whether light passes through. Light will pass through a mass or swelling caused by a hydrocele but will not pass through a solid mass.

The fluid buildup of a hydrocele generally does not require treatment unless it becomes too large or bulky.

Non-surgical treatment

• Observation: For non-bothersome small hydroceles or in patients with significant medical issues, observation may be all that is needed.
• Aspiration: In select circumstances, draining the fluid in the hydrocele sac may be performed; however, this typically has a high recurrence rate.

Surgical treatment

• Hydrocelectomy: This outpatient surgery involves a small incision in the scrotum to remove all or part of the hydrocele sac. The surgeon may leave a tube to drain fluid for a few days. Recurrence of a hydrocele is possible but not common.