Hernias and hydroceles are similar problems. They most commonly affect boys, although girls can develop issues, too. The conditions may be hereditary.
A hydrocele is a collection of fluid in the scrotal sac of male infants. A baby’s scrotum may appear swollen or large. Sometimes the fluid will go away within six to 12 months. If it doesn’t, surgery may be required to prevent additional complications.
Testicles develop near kidneys and descend to their normal position in the scrotum just before a boy is born. For the testicles to leave the abdomen, a muscle ring in the groin on each side opens, allowing the testicles to drop. As the testicles descend, the abdominal lining also drops to line the scrotum. This channel usually closes.
If it remains open, or reopens, fluid can leak to the scrotum, resulting in hydrocele. If the channel remains opens or reopens widely, some of the intestine can pass down toward the scrotum, leading to a hernia.
Hydroceles can also develop from inflammation or injury within the scrotum. Hernias can also result from increased pressure that forces part of the intestines through a weak spot in the abdominal wall.
Hernias and hydroceles are common. Although several family members may experience them, there is no evidence that they are inherited or that a parent could have prevented them. Girls do not develop hydroceles. They can develop hernias. Because of their anatomy, girls are 10 times less likely than boys to develop hernias.
- Hydrocele — About 10% of male infants have a hydrocele at birth. Seldom causing symptoms, this swelling of the scrotum does not bother a baby. It usually disappears in the first year, even though the appearance may worry parents. In older males, a hydrocele usually remains painless but may cause discomfort due to the increased size of the scrotum.
- Hernia — Only about 25% cause pain or discomfort. However, you may be able to see and feel the bulge. About 1% of boys develop hernias with premature infant males having a higher incidence.
- Hydroceles — Require surgical repair if they cause symptoms, such as growing large or changing size significantly during the day.
- Hernias – Do not go away on their own and may cause problems with digestion leading to emergency surgery. We usually recommend surgery to repair the muscle ring that did not close properly. In infants and children, a small incision is made in the groin through which we suture or sew the channel shut and repair the muscle ring. This procedure can be done in an outpatient setting. In teenagers, laparoscopic surgery may be considered.
- Discomfort requiring pain medication.
- Restriction on full activity for a couple of weeks, depending on your son’s age and whether both sides were treated.
- Testicles and scrotum may remain swollen for several weeks after surgery before returning to normal. After surgery, less than 1% of cases have a hernina or hydrocele return.