Diagnosis

Your doctor will start with a physical exam. It's likely to include:

  • Checking for tenderness in an enlarged scrotum.
  • Applying pressure to the abdomen and scrotum to check for inguinal hernia.
  • Shining a light through the scrotum (transillumination). If you or your child has a hydrocele, transillumination will show clear fluid surrounding the testicle.

After that, your doctor might recommend:

  • Blood and urine tests to help determine if you or your child has an infection, such as epididymitis
  • Ultrasound to help rule out hernia, testicular tumor or other causes of scrotal swelling

Treatment

In baby boys, a hydrocele sometimes disappears on its own. But for males of any age, it's important for a doctor to evaluate a hydrocele because it can be associated with an underlying testicular condition.

A hydrocele that doesn't disappear on its own might need to be surgically removed, typically as an outpatient procedure. The surgery to remove a hydrocele (hydrocelectomy) can be done under general or regional anesthesia. An incision is made in the scrotum or lower abdomen to remove the hydrocele. If a hydrocele is found during surgery to repair an inguinal hernia, the surgeon might remove the hydrocele even if it's causing no discomfort.

After hydrocelectomy, you might need a tube to drain fluid and a bulky dressing for a few days. Your doctor is likely to recommend a follow-up examination because a hydrocele might recur.

Preparing for your appointment

You might be referred to a urologist. Here's some information to help you get ready for your appointment.

What you can do

  • List symptoms you or your child has had and for how long
  • List all medications, vitamins and supplements you or your child takes, including the doses
  • List key personal and medical information, including other conditions, recent life changes and stressors
  • Prepare questions to ask your doctor

For hydrocele, some basic questions to ask your doctor include:

  • What do you think is causing this swelling? Are there any other possible causes?
  • What kinds of tests are needed?
  • What treatment do you recommend, if any?
  • What signs or symptoms will indicate that it's time to treat this condition?
  • Do you recommend any restrictions on activity?

Don't hesitate to ask other questions that arise during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions.

If your child is affected, your doctor might ask:

  • When did you first notice this swelling? Has it increased over time?
  • Is your child in any pain?
  • Does your child have any other symptoms?

If you're affected, your doctor might ask:

  • When did you first notice the swelling?
  • Have you had any discharge from your penis or blood in your semen?
  • Do you have discomfort or pain in the affected area?
  • Do you have pain during intercourse or when you ejaculate?
  • Do you have a frequent or urgent need to urinate? Does it hurt when you urinate?
  • Have you and your partner been tested for STIs?
  • Do your hobbies or work involve heavy lifting?
  • Have you ever had a urinary tract or prostate infection or other prostate conditions?
  • Have you ever had radiation or surgery in the affected area?

What you can do in the meantime

If you are a sexually active adult, avoid sexual contact that could put your partner at risk of contracting an STI, including sexual intercourse, oral sex and any skin-to-skin genital contact.

Oct. 19, 2017
References
  1. AskMayoExpert. Scrotal mass. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  2. Eyre RC, et al. Evaluation of nonacute scrotal pathology in adult men. https://www.uptodate.com/contents/search. Accessed July 17, 2017.
  3. Brenner JS, et al. Causes of painless scrotal swelling in children and adolescents. https://www.uptodate.com/contents/search. Accessed July 17, 2017.
  4. Wein AJ, et al. Tuberculosis and parasitic infections of the genitourinary tract. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed July 17, 2017.
  5. Wein AJ, et al. Management of abnormalities of the external genitalia in boys. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed July 17, 2017.
  6. Eyre RC, et al. Evaluation of the acute scrotum in adults. https://www.uptodate.com/contents/search. Accessed July 17, 2017.
  7. AskMayoExpert. Scrotal pain. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  8. Ferri FF. Hydrocele. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed July 17, 2017.
  9. AskMayoExpert. Male infertility. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  10. Brenner JS, et al. Evaluation of scrotal pain or swelling in children and adolescents. https://www.uptodate.com/contents/search. Accessed Aug. 17, 2017.
  11. Wein AJ, et al. Surgery of the scrotum and seminal vesicles. Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed July 17, 2017.