A hydrocele is an abnormal fluid collection between the tissue layers surrounding the testicle. It can be congenital (present since birth) or it can develop spontaneously later in life. It often presents as a progressively enlarging scrotal swelling. Although often painless, it can be associated with discomfort from the weight of the fluid or stretching of the scrotal skin.
Any persistent pain or swelling in the testis or scrotum should be evaluate by a physician, and when indicated, a urologist to rule out more serious condition. Your physician may order a scrotal ultrasound to evaluate the appearance of the testis or to rule out other diagnosis such as hernia, hematoma or abscess.
Since a hydrocele is a benign condition, treatment is based on the size of the hydrocele and the degree of patient's bother. The standard treatment for hydrocele is a minor surgery called "hydrocelectomy." During this procedure, a small incision is made in the scrotum, the fluid is drained, and the sac containing the fluid is excised and imbricated to decrease the risk of recurrence. An alternative treatment option is percutaneous drainage which has a high recurrence rate and therefore typically only offered to poor surgical candidates with high degree of bother.