Hydrocele in Children: Causes, Symptoms, and Treatments

1. What is Hydrocele in Children?

A hydrocele is a fluid-filled sac that develops around one or both testicles. This fluid, typically a painless swelling and could be in clear and yellowish colour, accumulates within the tunica vaginalis, a membrane surrounding the testicles. Hydrocele in children is surprisingly common, even it could appear in older children as well. About 10% of male infants are born with hydrocele. While some of them resolve on their own, some require medical attention.

2. Types of Hydrocele

Understanding the different types of hydrocele helps parents better comprehend their child’s condition:

a. Communicating Hydrocele

This type is connected to the abdominal cavity through a patent processus vaginalis (a small tube that allows the testicles to descend earlier than they start growing). The size of a communicating hydrocele can vary through the day, you might often notice it’s larger in the morning or till evening it might become small. This is because fluid can circulate freely between the stomach and the scrotum. This is more common in younger children.

b. Non-communicating Hydrocele

In this type, the connection to the abdominal cavity is closed. Non-communicating hydroceles are often present at birth and might solve on their own over time. The fluid is trapped within the scrotum, due to which the size of a non-communicating hydrocele generally remains stable.

3. Causes of Hydrocele in Children 

The causes of hydrocele depends on the child’s age:

a. In Newborns

The most common reason is that the processus vaginalis failed to properly close during the early stages of fetal development. This is a natural part of testicular descent before birth. In a few cases, some genetic factors could play a role. This incomplete closure allows fluid to build up across the testicles, which leads to the formation of a hydrocele.

b. In Older Children

In older children, a hydrocele might develop due to injuries of the scrotum, inflammation, underlying diseases, or rarely due to infection. Trauma, too, can disrupt the delicate balance of fluid inside the scrotum.

4. Hydrocele Symptoms and Signs 

Basic Physical Signs

The number one symptom of a hydrocele is a painless swelling of the scrotum. The swelling is normally:

• Smooth and soft to the touch.
• Impacts only one side, but it can have an effect on both.
• Is large in the evening (mainly in communicating hydroceles).

When to Seek Medical Attention? 

While many hydroceles are benign, and require immediate medical attention if:

• There’s a sudden increase in swelling.
• Your child experiences pain or discomfort in the scrotum.
• The scrotal area is red, warm, or tender to the touch.
• You observe any adjustments for your child’s behaviour indicating discomfort. Prompt analysis and suitable hydrocele treatment are important in such times.

5. Treatment of Hydrocele 

• Non-surgical options 

In many cases, hydrocele in kids resolves without medical intervention. Doctors may recommend a watch-and-wait approach, especially in infants, as the condition often improves within the first year of life.

• Surgical Option 

Hydrocele surgery may be recommended if the hydrocele is large, persistent, causing discomfort, or associated with other problems. The surgery of hydrocele treatment is known as hydrocelectomy, the process involves draining the fluid and closing the processus vaginalis to prevent recurrence. Surgery is generally recommended if the hydrocele persists beyond the first year or causes discomfort. The success rate for hydrocele surgery is high, and recovery is typically quick. Ensure you prepare your child with the surgery process by explaining what to expect, this can be helpful for him to ease the anxiety and cope up with the process. 

6. Post-surgery care and follow-up 

After hydrocele surgical treatment, careful post-operative care is essential for optimal recovery.

Home Care Considerations

• Make sure you keep the surgical area clean and dry.
• Always notice the signs of infection, including redness or discharge.
• Follow all of the post-surgical care that your doctor prescribes for you.

Lifestyle Considerations

• For a few weeks, be restricted in terms of the degree of physical activities which could give additional pressure on the groin.
• Dress your child in loose clothes to avoid any discomfort and irritation.
• Keep visiting your doctor for follow-ups and according to their advice, your child can return to regular activities.