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Hydrocele & Hernia

A hydrocele, sometimes accompanied by a hernia, is an abnormality of the testicles in a newborn male. A hydrocele is when fluid fills the scrotum (the sac which houses the testicles). This causes the testicles to appear larger or swollen.

A hernia is when some of the contents of the abdomen fall out of the body. This creates a bulge under the skin. In males, the abdominal contents can fall to the scrotum. It can occur in both males and females, though is more common in males.

A hydrocele or hernia can occur in one or both sides of the body. These are found in 1-4% of full-term births and up to 30% of premature births.

There are several types of hernias. The medical term for the hernia referred to on this page is indirect inguinal hernia.

Symptoms

Some symptoms of a hydrocele include:

  • Swollen or enlarged scrotum
  • Scrotum increases in size as the day passes or with activity
  • Tense skin of the scrotum
  • Scrotum appears bluish in colour
  • Not painful

Some symptoms of a hernia include:

  • A bulge in the crease where the leg attaches to the abdomen.
  • A bulge of the scrotum in male infants
  • Not painful
  • Enlarges when the child cries or strains
  • Fussiness or irritability

Reference Articles

Causes

A hernia or a hydrocele in a male foetus have similar causes. During development in the womb, the testicles form in the abdomen. They then move downward. They pass through a small hole before coming to rest in the scrotum. Normally, the hole closes in the last few weeks of pregnancy or in the first few months of life.

If the hole does not close, fluid from the abdomen can leak into the testicles and become trapped. A buildup of this fluid is called a hydrocele.

Other structures from the abdomen, such as the intestines or other tissue, can fall through the hole into the scrotum as well. This is called a hernia.

In a female foetus, a hernia can occur because of a weakness in the muscle of the abdominal wall. Intestines, fat, other membranes from the abdomen, or parts of the female reproductive system may fall through the opening into the groin.

Risk Factors

There are several factors for developing a hydrocele or hernia, such as:

  • Being born too early (premature)
  • Being born too light (low birth weight infant)
  • Being male

Diagnosis

Often, a parent or a doctor doing a routine examination first notice a hydrocele or hernia.

A doctor may request a scan to confirm the diagnosis. The most common imaging techniques for this are ultrasound or CT scan.

Complications

While most hydroceles and hernias are not serious, there are some potential complications, such as:

  • Haematocele – collection of blood in the scrotal sac
  • Strangulated or incarcerated hernia – when a fold of intestine becomes twisted or stuck in the opening or in the scrotum. This causes intense pain and requires emergency surgery
  • Testicular torsion – when the testicle rotates on its cord, thus cutting off the blood supply. This also requires emergency surgery

Treatment

The treatment for a hernia is surgery, as it will not get better on its own. This is usually a routine operation for full-term infants or older children. As pre-term infants have a higher risk for complications, the surgery should ideally be performed within a week of diagnosis.

A hydrocele without a hernia will often get better on its own with time. For this reason, a doctor may recommend watching it for the first one to two years of life. Unfortunately, there is no way to prevent the development of a hernia or hydrocele.

 
 
 

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