Hydrocoele

A hydrocoele is a soft, painless swelling of the scrotum caused by fluid gathering in the thin sac that surrounds the testis. It occurs when the small passage between the abdomen and the scrotum, which normally closes around birth, stays open and lets fluid trickle down.

The swelling may be on one side or both and can vary in size through the day, often looking larger in the evening or after activity. Hydrocoeles are very common in newborn boys and are not dangerous. They do not harm the testis and are not caused by anything you did during pregnancy or after birth.

In babies, the open passage usually closes on its own during the first year or two of life and the fluid is gradually absorbed, so no treatment is needed other than watching and waiting.

• Your child's surgeon may recommend an operation if the hydrocoele:
• Is still present after around two years of age
• Appears for the first time in an older child
• Becomes very large, tense or uncomfortable
• Changes in size in a way that suggests an associated inguinal herniaHydrocoeles and inguinal hernias are closely related, and the surgeon will check carefully for a hernia during your child's assessment.

Hydrocoele repair is performed under a general anaesthetic and is almost always day surgery. Local anaesthetic is used as well to keep your child comfortable after waking.

A small incision is made in the groin crease, very much like an inguinal hernia repair. The open passage carrying the fluid is closed with stitches and the fluid is drained. Simply drawing off the fluid with a needle is not recommended as it comes back. The wound is closed with dissolving stitches under the skin and covered with a small dressing or skin glue. The operation usually takes less than an hour.

Children recover quickly and usually need only paracetamol or ibuprofen for a day or two. Some swelling and bruising of the scrotum is expected and can take several weeks to settle completely, so do not be alarmed if it still looks a little full at first.

Bathing is fine after a day or two depending on the dressing. Older children should avoid bikes, straddle toys and rough play for around two weeks. Contact the team if your child develops a fever, the wound becomes red or leaks, or the swelling becomes hard and painful. A follow-up visit will be arranged to check the result.