Hydrocele: Meaning, Symptoms, and Causes

A hydrocele is a common condition that occurs in males when fluid builds up in the sac around the testicles (the scrotum). A little bit of fluid is present in the tunica vaginalis sac, which functions as a lubricant to liberate the testicles from obstruction.

In a hydrocele, too much fluid builds up in the sac, causing swelling and enlargement of the scrotum. This swelling may be painless, but it can cause discomfort or a feeling of heaviness in the scrotum.

Hydroceles may disappear on their own. They are typically harmless. But if the swelling gets big or hurts, you could need medical attention. To drain the fluid or treat the underlying cause of the hydrocele, surgery may also be required.

There are two types of hydroceles:              

1. Communicating Hydroceles

1. These hydroceles have contact with the fluids of the abdominal cavity.
2. Communicating hydrocele is caused by the processus vaginalis, a thin membrane that extends through the inguinal canal in the belly and into the scrotum, failing to close.
3. Generally, these openings close before birth or soon after.
4. When this membrane remains open, there is a chance of developing a hernia and a hydrocele.
5. Newborns and children are more likely to develop this type of hydrocele.
6. Communicating Hydroceles may resolve on its own within the first year of life. However, if it persists beyond that, surgery may be necessary to repair the connection and prevent further complications.            

2. Non-Communicating Hydrocele

1. This type of hydrocele is characterized by extra fluid around the testicle in the scrotum. They occur when the inguinal canal is closed. 
2. This condition might develop years later for no apparent reason or might be present at birth.
3. Hydroceles may be caused after surgery or an injury to the groin area or the scrotum.
4. Adult hydroceles may occur due to an infection or inflammation of the testicles or epididymis.
5. In some infrequent scenarios, hydroceles can also occur with cancer of the testicle or left kidney.
6. Non-communicating hydrocele may require surgery to drain the fluid and prevent a recurrence.

It is always worrying when something is wrong with the children, but it can be a particular concern when the condition affects their genitals. Swollen testicles are a hydrocele symptom. Other hydrocele signs and symptoms are as follows:

• Swollen or large scrotum that may change in size throughout the day
• Prolonged growth of the scrotum. This occurs most often in the non-communicating type of hydrocele.
• Discomfort and immobility due to the enlarged size
  
• Pain in the groin region
• Swelling or redness of the scrotum
• Pressure at the base of the penis
• Swollen testicles (either one or both)

Hydrocele is a condition that occurs when fluid accumulates in the scrotum, causing swelling and discomfort. Hydrocele causes can vary depending on the age of the individual or the condition because of which hydrocele occurs. Some of the common reason for hydrocele
are as follows:

1. Premature Babies: Hydrocele is relatively common in newborns, especially premature babies. It occurs when fluid from the abdomen accumulates in the scrotum through the patent processus vaginalis, a channel that connects the abdomen to the scrotum. In most cases, this condition resolves on its own within the first year of life.
2. Inflammation: In children, the hydrocele may occur due to an injury, infection, or inflammation of the scrotum. Inguinal hernia, a condition in which a part of the intestine protrudes through the inguinal canal and into the scrotum, can also cause inflammation.
   
3. Sexually Transmitted Infection: In young adults, hydrocele can be caused by a sexually transmitted infection, such as gonorrhoea or chlamydia.
4. Underlying Medical Condition: The hydrocele in older persons may be brought on by an underlying medical disease such as heart or renal failure, liver cirrhosis, or lymphatic system obstruction. Underlying medical conditions can cause an accumulation of fluid in the body and the development of a hydrocele.

Although it is not always possible to prevent a hydrocele, there are some measures that can reduce the risk of developing one.

1. In the case of infants, as the hydrocele occurs in the womb, there is nothing you can do to prevent them from getting a hydrocele.
2. Hydroceles can be prevented in adult and adolescent men by preventing an injury to the testicles and scrotum. 
3. Special care, such as wearing an athletic cup, should be taken while playing sports.

Hydrocele is usually not very threatening and might go on their own. However, you should still seek medical attention for it if it does not go away on its own. Your doctor can do a hydrocele examination through a sequence of tests, including:

1. Physical Exam: At first, a doctor will observe the bulging and enlargement of the scrotum. Your doctor may request you to cough to notice the changes in the groin area under pressure.
2. Transillumination: As part of the test, your doctor will shine a light behind each testicle, which will highlight any accumulation of fluid in that region. If the light does not pass through the scrotum, the solid masses might indicate the presence of cancer.
3. Ultrasound: Ultrasound is recommended by doctors if the scrotum feels hard to the touch or inflamed. Ultrasound will confirm the cause of the swelling. Ultrasound also helps with the diagnosis of testicular torsion. It is a serious condition where your testis might lose blood supply, it would require immediate medical attention.
4. Urine and Blood Tests also can be used to learn if the patient has an infection or an inflammation.

When to Seek Advice? 

 You should seek medical help right away if you observe the following symptoms:

• Enlarged scrotum, mainly observed in infants.
• Mild pain in the groin region.
• Scrotal tenderness.
• Redness and inflammation of the testis.
• Inguinal hernia (displacement of the tissue outside its cavity).
• Your infant seems to be nauseated.
• Your infant is vomiting.

Whenever there is any issue in the body, one always look for non-surgical treatments or home remedies to treat the problem. 

Although many men tend to hide or feel hesitant to discuss their problems because of the embarrassment. But you need to understand that hydrocele is just another health issue that requires proper treatment without making any fuss about it. 

So, if you are also suffering from the hydrocele problem right now, here are some effective hydrocele treatment options for you. It will release your tension to know that surgery is not the only option to treat hydrocele.

Home Remedies 

Home remedies are natural remedies or treatments that can be done at home using readily available ingredients to alleviate common health problems. 

Some of the home remedies that may help are as follows:

• Ice Pack: Applying a cold compress to the affected area can help reduce swelling and discomfort. Wrap some ice in a towel and apply it to the scrotum for about 15 minutes at a time. 
• Supportive Underwear: Wearing supportive underwear, such as a jockstrap, can help reduce discomfort and provide support to the scrotum.
• Elevation: Elevating the affected area while sitting or lying down can help reduce swelling.
• Warm Bath: Taking a warm bath or using a warm compress may help alleviate discomfort and reduce swelling.
• Epsom Salt: A hydrocele's discomfort, soreness, and pain can be efficiently relieved by taking an Epsom salt bath twice or three times per week. Additionally, it improves blood flow to the area around the scrotum.

Dietary Changes

Dietary modifications refer to making changes to one's diet in order to improve overall health and address specific health conditions. 

Hydroceles can be treated in many ways. However, you should also remember that your diet plays an important role in improving your symptoms. Our diet has a direct impact on our health. 

Some dietary modifications that may be helpful for individuals with hydrocele include:

• Maintain a Healthy Diet: Foods rich in vitamins, minerals, and antioxidants that can strengthen your immune system and reduce inflammation in the body. Eating a variety of colourful fruits and vegetables can also help reduce your risk for other health conditions, such as heart disease and cancer.
• Avoid Processed and High-Fat Foods: Processed foods often contain high amounts of sodium, sugar, and unhealthy fats, which can contribute to inflammation and other health problems. Instead, choose whole, nutrient-dense foods that are low in added sugars and unhealthy fats.
• Turmeric Tea: Turmeric has anti-inflammatory properties that may help reduce swelling associated with hydrocele. Mix 1 teaspoon of turmeric powder with a glass of warm milk and drink it daily.
• Ginger: Anti-inflammatory properties of ginger can also help in reducing swelling. Drink ginger tea or add fresh ginger to your food.
• Apple Cider Vinegar: It has been utilised for several medical conditions over the years, including hydrocele. Drink a glass of warm water with 1-2 teaspoons of apple cider vinegar every day.

Lifestyle Modifications

Physical activity is as important as any healthy diet. Lifestyle changes refer to modifications in one's daily habits and activities that can promote overall health and well-being.

Some lifestyle changes that may be beneficial for individuals with hydrocele include:

• Staying Hydrated: Constipation, which may lead to hydroceles and other health issues, can be avoided by drinking enough water and other fluids. Constipation can also assist keep your body hydrated.
• Weight Management: Maintaining a healthy weight can help reduce the strain on the body and promote circulation, which can be helpful for managing hydrocele.
• Avoid Tight Clothing: Wearing tight clothing, particularly around the groin area, can worsen swelling and contribute to the development of hydrocele.
• Avoid Heavy Lifting and Strenuous Activities: These activities can put a strain on the body and contribute to the development or worsening of hydrocele.

Non-Surgical Treatment of Hydrocele

In the case of hydrocele non-surgical treatments may not eliminate the hydrocele completely, but they can be useful in reducing inflammation and improving circulation in the body, which can help reduce the swelling associated with the condition.

Some of the non-surgical treatments that can help in the treatment of hydrocele are as follows-

Needle Aspiration: 

1. In patients who cannot tolerate surgery, aspiration can be done. 
2. Aspiration is a less invasive procedure that involves using a needle to drain the fluid from the scrotum. However, this procedure is not a permanent solution, and the fluid may accumulate again.
3. The accumulated fluid is removed via a needle in this technique. However, the fluid within the hydroceles often recollects in a week or so. 
4. There is also a risk of haematocele and infection after aspiration. 
5. If the hydrocele gets enlarged again, surgery to remove the hydrocele (hydrocelectomy) is recommended by doctors.

Sclerotherapy: In this procedure, the surgeon injects a chemical solution into the sac that produces the fluid, causing it to shrink and eventually close off. This procedure is only effective for non-communicating hydroceles.

Surgical Treatment for Hydrocele

Normally, non-surgical treatments may help to reduce the symptoms of hydrocele but they can not cure it completely. There is always surgical methods to treat hydrocele.

When hydrocele becomes complicated or symptomatic, surgery is the option recommended by doctors. 

For infants, the surgery focuses on sealing the processus vaginalis, which should have closed on its own before birth. However, surgery is preferred for adult men when the hydrocele's swelling is embarrassing and painful. 

It can also be done when the hydrocele grows to a size that threatens the function of the rest of the genital tissues.

Surgical Approach for Hydrocele Treatment

1. Open Hydrocelectomy: This is the most common type of surgery for hydrocele. Open Hydrocelectomy involves making an incision in the scrotum and draining the fluid. The surgeon then removes the sac that is responsible for producing the fluid. This type of surgery is effective for both communicating and non-communicating hydroceles.
2. Hydrocele laser surgery or laser-assisted hydrocelectomy involves using a laser to make a small incision in the scrotum to drain the fluid. During the procedure, a small fibre optic laser is inserted through a tiny incision in the scrotum. The laser energy is then used to make a small hole in the sac that contains the fluid. The fluid is drained out of the sac and the hole is then sealed using laser energy.

Cost of Hydrocele Surgery

The first thought that may come to mind while considering the surgery is the cost. The price of the surgery varies on multiple factors like the choice of hospital, type of surgery, etc. The cos of hydrocele surgery are as follows: 

Surgery Name	Surgery Cost
Open Hydrocelectomy	₹17,000 to ₹50,000
Laser Hydrocelectomy	₹20,000 to ₹90,000

Usually, hydrocele is not dangerous, but if it is not treated in time, it can cause worsening hydrocele symptoms that would be troublesome and will interfere with your daily activities. Delaying the treatment of a hydrocele can result in severe outcomes, such as:

1. Inguinal Hernia: If a communicating hydrocele is not treated or does not go away on its own, it can progress to an inguinal hernia. In this condition, part of the intestine or digestive fat pushes through an orifice (inguinal canal) in the pelvic area.
2. Testicular Torsion: This condition can occur if the hydrocele goes untreated for a more extended period. In this painful condition, the spermatic cord gets tangled and cuts off blood flow to the testicle. There is a higher chance of infertility and loss of the testicle if this condition goes untreated for more than six hours.
3. Orchitis and Epididymitis: Testicular swelling of hydrocele might lead to another scrotal condition known as orchitis. 
4. Varicoceles are swollen veins in the scrotum that can impair sperm production and quality, leading to low sperm count and potential infertility. A hydrocele can sometimes be associated with a varicocele, although this is also uncommon.
5. Infertility: Infections such as epididymitis or orchitis, which can be associated with a hydrocele, can cause inflammation and scarring that can block or damage the tubes that carry sperm, potentially leading to infertility.

In conclusion, while a hydrocele may seem concerning at first, it is typically a harmless condition that does not require immediate medical attention. 

Despite being more common in newborns, hydrocele can develop at any age. The development of these may be influenced by underlying injuries or even inflammation. A hydrocele is nothing more than a temporary and inconvenient condition for most people. It is easily diagnosed and can be confirmed with a physical exam or an ultrasound. 

In most cases, a hydrocele doesn't require treatment unless the swelling gets big enough to be uncomfortable or embarrassing or if it interferes with regular activities. Your doctor could advise surgically removing the hydrocele or draining the fluid in these circumstances.

If you have any concerns about hydrocele, it is always best to consult with your healthcare provider for proper diagnosis and treatment recommendations. At HexaHealth, we have a team of expert medical professionals who can help you treat hydrocele without any hassle. Visit our website to get in touch with us right now!