Hydrocele in infants

Overview

A hydrocele (HI-dro-seel) is a harmless fluid-filled sac around a testicle that causes swelling in a baby boy's scrotum (the pouch of skin that holds the testicles). The fluid usually goes away on its own within the first year of life.

Yes, hydroceles are common in newborn boys. Up to 1 in 10 male babies may have one at birth.

Hydroceles mainly affect newborn baby boys, particularly those born before their due date (premature).

Symptoms

Common symptoms

• Painless swelling in one or both sides of the scrotum
• The swelling feels like a small water balloon and may get slightly bigger during the day
• The scrotum may look bluish or clear when a light is held behind it (this is called transillumination)

Symptoms in children

• Same as common symptoms, but in older children a sudden increase in size or pain may indicate a different problem

Symptoms in older adults

• Hydroceles are rare in older adults; swelling of the scrotum in this age group may be due to other conditions and should be checked by a doctor

Causes

Main causes

• Before birth, a small passage called the processus vaginalis allows fluid to flow from the belly into the scrotum. If this passage does not close properly after birth, fluid collects and forms a hydrocele.
• In premature babies, this passage is more likely to remain open, making hydroceles more common.

Risk factors

• Premature birth (born before 37 weeks)
• Family history of hydrocele or inguinal hernia (rarely)

When to see a doctor

See a doctor urgently if:

• If the baby has any of the emergency symptoms listed above
• If the swelling suddenly becomes painful, red, or hard

Book a routine appointment if:

• If the swelling does not go away by the baby's first birthday
• If you are worried and would like reassurance that the swelling is a hydrocele and not something else

Diagnosis

A doctor will examine the baby's scrotum. They may shine a small light (transillumination) through the swelling – if it glows, it's likely fluid rather than a solid lump.

Tests that may be done

• Usually no tests are needed. If the doctor is unsure, they may recommend an ultrasound scan to confirm it is fluid and rule out a hernia or other problem.

What to expect at your appointment

The doctor will gently feel the scrotum and may try to see if the swelling changes size when the baby cries or lies down. The visit is quick and non-invasive, and the doctor will explain how to monitor the swelling at home.

Treatment

Most infant hydroceles need no treatment. The body reabsorbs the fluid naturally, usually within the first 12 months. Treatment is only considered if the hydrocele persists beyond age 1–2 or causes discomfort.

Self-care at home

• No special self-care is needed; just keep the area clean and dry during diaper changes.
• Watch for changes in size, colour, or the baby's comfort. A diary of the swelling can help your doctor.
• Do not try to squeeze or drain the fluid yourself.

Medical treatments

If the hydrocele does not go away on its own, a doctor may recommend a minor surgical procedure called hydrocelectomy. This involves draining the fluid through a small cut and closing the passage to prevent it from returning. Surgery is done under general anaesthetic and is very safe.

When is surgery considered?

Surgery is usually considered if the hydrocele is still present after the baby turns 1 year old, or if it becomes a hernia (a loop of intestine pushes into the scrotum). Your paediatric surgeon will discuss the best timing.

Living with this condition

A baby with a hydrocele can be treated just like any other baby. The swelling does not cause pain or limit activity. You can bathe, dress, and cuddle your baby normally.

Lifestyle tips

• No changes to daily routines are needed.
• If your baby seems fussy, the swelling is unlikely to be the cause – check for other reasons like hunger or a wet diaper.

Diet and exercise

No special diet or exercise is needed. Follow your baby's normal feeding and play schedule.

Mental health and emotional wellbeing

Parents may feel anxious about a lump in their baby's scrotum. Remember that most hydroceles are harmless and temporary. If worry affects your daily life, talk to your doctor or a counsellor who can provide reassurance.

Prevention

Hydroceles in infants cannot be prevented, as they develop before birth. They are not caused by anything a parent does or doesn't do.

Complications

If left untreated

• Very rarely, a hydrocele can develop into a hernia if the passage remains open and a piece of intestine slides down.
• Persistent hydroceles after age 2 may rarely cause mild discomfort or cosmetic concerns.

Long-term outlook

The outlook for infant hydroceles is excellent. Almost all resolve on their own without any treatment or complications. Even if surgery is needed, it is a simple procedure with full recovery expected.

Find support

Local organisations

• Your paediatrician or local health clinic · General

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