Are your baby's testicles swollen? This is about Hydrocele (water accumulation in the testicles)!

Have you ever been scared to see one or both of your little boy's testicles swollen up a bit, like a small water balloon? Many parents get worried when they see this. But this condition is usually nothing to worry about. In medical terms, we call it a hydrocele. In simple Sinhala, it's a collection of water around the testicles. So, let's talk about this in a clear and simple way today. Let's find out what it really is, why it happens, and what we should do.

Simply put, what is Hydrocele?

A hydrocele is a swelling of the scrotum, the sac of skin that contains your testicles. It can occur on one side of the scrotum, or on both sides. Sometimes, when both sides are swollen, it is called a bilateral hydrocele.

Although this condition can occur in men of any age, it is most common in newborn baby boys. However, it can sometimes occur suddenly for no apparent reason in adults.

Is this a serious, dangerous situation?

The testicles are a very sensitive area, so it's natural to be concerned when you see a lump there. Sometimes, if this lump gets a little big, you may feel a little uncomfortable when sitting or walking.

There are two main types of hydrocele:

We divide this situation into two main types. There is a slight difference between the two.

1. Communicating hydrocele

2. Noncommunicating hydrocele

Now let's simply understand what these two are.

Communicating Hydrocele

This happens because of something that happens when the baby is in the womb. Imagine that there is a small passage, or tube, between the abdominal cavity and the scrotum. We call this the 'processus vaginalis'. Normally, the baby's testicles descend along this path from the abdominal cavity, into the scrotum, and then this path closes off.

But in some babies, this passage doesn't close properly. Then some of the fluid from the abdomen comes down this passage and collects in the scrotum. "Connected" means "connected" because there is still a connection to the abdominal cavity. In this type, the swelling may increase and decrease throughout the day. The swelling may be more noticeable at night than in the morning.

Noncommunicating Hydrocele

In this type, the processus vaginalis, which I mentioned earlier, is completely closed. But before it closes, some fluid has entered the scrotum and is trapped there. This means that there is no way for new fluid to come in or for the existing fluid to go back out. In this type , the swelling usually remains the same size, or it gets very large.

See this table to further explain the difference between these two types.

What are the symptoms of a hydrocele?

The main and most obvious symptom is swelling on one or both sides of the scrotum. This swelling may feel soft to the touch, like a small ball of water. There may be other symptoms as well.

• The amount of swelling changes throughout the day.
• Feeling some discomfort, even if there is no pain.
• Some people (especially adults) may feel some pain.
• Feeling of heaviness in the scrotum.

Does this affect fertility?

This is a problem that many people have. But the good news is that hydrocele usually does not affect fertility.

Why does this Hydrocele occur?

The reason for this may vary depending on age.

For newborn babies

As I mentioned earlier, this happens to babies as part of their development in the womb. The main reason is that the processus vaginalis, the passage between the abdominal cavity and the scrotum, does not close properly. Sometimes, even if that passage closes, some fluid can get trapped inside.

The best part is that most babies' bodies gradually absorb this fluid and the swelling goes away completely within the first year or two. About 10% of newborn boys experience this condition, so it's very common.

For young children and adults

If this occurs in an older person, other factors may be involved.

• An injury or blow to the scrotum area.
• There may be some infection or inflammation in that area.

This condition affects about 1% of adults, and in most cases, it goes away without treatment.

How does a doctor recognize this?

When you go to see a doctor, he will follow several steps to confirm whether it is a hydrocele.

1. Asking questions: Asking you or your child about their symptoms.

2. Physical examination: The doctor will palpate the swollen area. They may press on the groin area a little, or ask you to cough. See if the swelling changes.

3. Transillumination: This is a very simple test. The doctor takes a small torch in a dark room and holds it to the swelling. If there is a liquid like water inside, the light passes through it and the entire swelling glows red. This can give the doctor a big idea.

4. Other tests: Most of the time, the above tests can confirm that it is a hydrocele. However, sometimes, if there is a suspicion that it is another condition, your doctor may refer you for other tests.

• Pelvic ultrasound: This can provide a clear image of the testicles and surrounding tissue. This is the most common scan used to confirm a hydrocele.
• CT scan: This is also a type of X-ray. However, it can produce clearer three-dimensional (3D) images.

What are the treatments for hydrocele?

This is the most important part. Most cases of hydrocele do not require any treatment.

In the case of babies, we usually wait until they are a year or two old. Because within that time it will go away on its own. Even in adults, if there is no pain or discomfort, you can wait until it heals on its own.

But,

• If the baby's swelling has not subsided after two years,
• If the swelling is very large,
• If it causes pain or great discomfort,
• Or if there is a risk of developing a communicating hydrocele and a hernia,

Then your doctor may recommend a minor surgery . We call this surgery a hydrocelectomy. This involves making a small incision, removing the fluid inside, and doing whatever is necessary to prevent the fluid from building up again. If it is a connected type, the passageway to the abdominal cavity is closed.

What happens if left untreated?

Usually, there is no problem. However, in the case of a communicating hydrocele, if the passageway with the abdominal cavity is very large and is not treated, a rare condition called an inguinal hernia can occur. This means that something, such as a part of the intestine, comes down through the passageway and gets stuck in the groin. It can be painful and sometimes dangerous.

When should you see a doctor?

If you notice a swelling in your son's scrotum, it's best not to panic and take him to the nearest doctor. This is to make sure that it's a hydrocele or something else. Especially if the following symptoms are present, you should definitely see a doctor.

Can this be prevented?

There is nothing we can do to prevent this from happening to newborn babies, because it is part of the body's development process.

However, for older children and adults, the best way to prevent a hydrocele is to protect the scrotum area from injury. If you are an athlete, it is very important to wear an athletic cup, especially when playing sports such as cricket or football.

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