Hydrocele – Diagnosis and Treatment
Diagnosis
To find a hydrocele, a health professional first performs a physical checkup. The doctor looks for signs like swelling in the scrotum, tenderness, or pain.
The doctor often presses gently on the scrotal tissues and the groin area to determine if there is a hernia.
A common step is transillumination. In this test, a doctor shines a light through the scrotum. If fluid surrounds the testicle or testes, the light passes through and shows up clearly.
If more information is needed, the provider may order an ultrasound. This imaging test helps identify a cyst, tumor, or other causes of fullness in the scrotum.
Sometimes, blood and urine tests help check for infection. This process helps both adults and newborns who have scrotal swelling.
Treatment
Most hydroceles in infants resolve on their own, so doctors usually do not treat them right away. However, if a hydrocele remains or causes symptoms, a doctor needs to check for other issues like a hernia.
Treatment Choices:
- Observation: If the hydrocele is small and painless, doctors may suggest waiting to see if it disappears.
- Medicine: Anti-inflammatory drugs or analgesics help manage discomfort if there is any pain.
- Surgery: If the hydrocele does not go away or causes problems, a surgeon may perform a procedure called hydrocelectomy. The surgeon makes a small cut in the scrotum or lower belly area to remove the fluid. An anesthesiologist provides general anesthesia so the patient does not feel pain during the operation.
- Aspiration: In rare cases, doctors might drain the fluid with a needle. Doctors rarely choose this option first because the fluid often returns.
| Treatment Option | Used For | Hospital Stay |
|---|---|---|
| Observation | Infants/small cases | No |
| Surgery (Hydrocelectomy) | Persistent or large hydroceles | Sometimes |
| Aspiration | Special cases | No |
Sometimes, a surgeon finds a hydrocele during surgery for an inguinal hernia and treats both at once. Recurrence can happen, so doctors may recommend follow-up exams after the procedure.
Getting Ready for Your Visit
Steps You Can Take Before Your Visit
- Write down symptoms. Keep a record of any pain, swelling, discomfort, redness, or pressure. Note if these symptoms began after an injury or if there are signs of inflammation or infection.
- Make a list of medicines and supplements. Include all prescription drugs, over-the-counter medicines, vitamins, and supplements, along with how much and how often you take them.
- Gather important health details. Note any past or current illnesses such as orchitis, epididymitis, varicocele, or testicular torsion. Include information about other infections or recent changes in health, life, or stress levels.
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Prepare questions. Bring a list of questions to ask the healthcare provider. These might include:
- What could be causing this problem?
- Are more tests needed to find out why this is happening?
- What treatment options are available?
- When is it necessary to treat this problem?
- Should there be any activity or work changes?
- Note any fertility concerns. If you have worries about having children in the future, include this on the list of topics to discuss.
Sample Table for Tracking Information:
| Information to Bring | Example |
|---|---|
| Symptoms | Swelling, pain, redness, injury |
| Medicines/Supplements | Ibuprofen 200mg daily |
| Medical History | Recent infection, history of STIs |
| Questions | What causes swelling? Treatment options? |
What Your Doctor Might Ask You
During the visit, the healthcare provider may ask about:
- The first time you noticed swelling and any changes since then.
- Whether you have pain, discomfort, redness, or signs of infection.
- Any history of injuries to the area, past inflammation, or pressure.
- Experiences with urination, such as a burning feeling, urgent need, or difficulty.
- Blood or discharge from the penis, pain during sex, or while ejaculating.
- Sexual history, including testing for STIs.
- Personal or family history of conditions like orchitis, epididymitis, varicocele, or testicular torsion.
- Work or hobbies that involve heavy lifting.
- Previous surgeries or radiation therapy in the pelvic area.
- For those with children, the doctor will ask similar questions about the childโs pain, swelling, or changes.
Precautions and Actions Until Your Visit
- Avoid any sexual activity that could expose others to infections if you might have an STI.
- Pay attention to new pain, increased swelling, or changes in the skinโs redness or warmth, as these could signal a more serious infection or injury.
- If you feel more discomfort or pressure, reduce physical activities, especially heavy lifting.
- Track any new or worsening symptoms so you can report them at the appointment.
- Keep the area clean and wear comfortable clothing to limit additional irritation.
