Hydrocele of the Testis
Urology · hydrocele of the testis · scrotal ultrasound · Gdańsk
Hydrocele is an accumulation of fluid around the testicle that causes scrotal swelling, a feeling of heaviness or discomfort. An inguinal hernia, epididymal cyst, varicocele, inflammation or testicular tumour can look similar — which is why any scrotal enlargement requires a urological assessment and, in most cases, an ultrasound scan.
Noticed scrotal swelling and unsure what it is? Start with a urological consultation. The urologist will assess the findings and, if needed, arrange a scrotal ultrasound.
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hydrocele, cyst, varicocele, inflammation, tumour
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What is a hydrocele of the testis?
A hydrocele is an accumulation of serous fluid within the tunics surrounding the testicle. As a result, the scrotum may enlarge and the patient notices asymmetry, a "balloon-like" swelling on one side, a feeling of tension or heaviness. A hydrocele may affect one or both testicles.
In adult men, a hydrocele may develop without an obvious cause or following trauma, inflammation, scrotal surgery, or as a consequence of other conditions. In children, some hydroceles are congenital and require a separate paediatric-urological assessment.
Key point: scrotal swelling is not a diagnosis. A hydrocele, inguinal hernia, epididymal cyst, varicocele, inflammation and testicular tumour can all look similar. Every new scrotal enlargement requires a urological assessment and, as a rule, a scrotal ultrasound.
Symptoms that most often bring patients in
- scrotal enlargement on one side — less often bilateral,
- feeling of heaviness or tension in the scrotum,
- discomfort when walking, sitting, exercising or during sexual activity,
- gradually increasing scrotal asymmetry,
- difficulty feeling the exact structure of the testicle through the skin,
- sensation of soft, fluid-filled swelling around the testicle,
- pain is less common — mainly when the hydrocele is very large or when inflammation coexists.
What else can look like a hydrocele?
Patients often say: "my testicle is swollen" or "there's fluid in my scrotum." In practice, the doctor must distinguish a hydrocele from other conditions with a similar appearance.
May descend into the scrotum — often changes size when coughing, straining or standing.
A fluid-filled lesion usually near the epididymis — most often felt above or behind the testicle.
Dilated veins, most often on the left side — feeling of heaviness that worsens with physical activity.
More often causes pain, tenderness, redness, fever or urinary symptoms.
May cause swelling, a hard lump or a change in consistency — sometimes painless. Requires urgent assessment.
May appear after a blow, procedure or exertion. Requires assessment to rule out other damage.
When to seek urgent help?
A typical hydrocele does not cause sudden, severe pain. If symptoms are acute or accompanied by fever — do not wait for a scheduled urology appointment.
Seek urgent medical attention or go to A&E if you experience:
- sudden, severe testicular or scrotal pain,
- rapidly increasing scrotal swelling,
- pain with nausea, vomiting or general weakness,
- fever, chills, redness and warmth of the scrotum,
- testicle positioned higher than usual or in an unusual position,
- a hard lump felt inside the testicle,
- pain following scrotal trauma.
Sudden, severe testicular pain may indicate testicular torsion — a condition requiring immediate medical help. A hard lump or a rapidly enlarging testicle requires investigation to exclude malignancy.
How is a hydrocele diagnosed?
Diagnosis begins with a patient history and urological examination. The doctor asks about the duration of symptoms, rate of progression, pain, trauma, past infections and chronic conditions.
Assessment of the scrotum, testicles, epididymides and groin. The doctor checks tenderness, consistency and rules out a hernia.
Image of the testicle, fluid volume, signs of inflammation, cysts, varicocele. The key tool for differential diagnosis.
Urology ultrasound →Ordered when a urinary tract infection or epididymitis is suspected as a cause of scrotal swelling.
Hydrocele treatment — what are the options?
The treatment approach depends on the size of the hydrocele, symptoms, the patient's age and the ultrasound result. Not every hydrocele requires immediate surgery. The urologist discusses the choice of method individually at the consultation.
A small, painless hydrocele with no significant discomfort may be observed if the doctor finds no concerning features after examination and ultrasound.
The fluid is drained with a needle. In some patients the fluid reaccumulates — aspiration is not always a definitive treatment.
When the hydrocele is large, growing or recurs after aspiration, the urologist may recommend surgery. Details are discussed individually.
The procedure scope, type of anaesthesia, possible risks and recovery are discussed individually with the patient during the pre-operative assessment. The choice of treatment method depends on clinical examination and ultrasound results.
What to do if you have scrotal swelling?
From the first symptom to a solution — in three steps.
The doctor examines the scrotum, testicles and groin. Assesses symptoms and decides whether ultrasound or further tests are needed.
Book consultation →The scan assesses the testicle, fluid volume, epididymis and excludes other causes — cyst, varicocele, testicular tumour.
Urology ultrasound →Observation, aspiration or referral for surgery — depending on examination and ultrasound findings. Individual decision.
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Urological consultations, scrotal ultrasound and assessment for treatment of testicular conditions.
urologist, andrologist
Urologist and andrologist specialising in diagnosis and treatment of scrotal, testicular, prostate and urinary tract conditions in men.
urologist
Urologist with clinical experience in consultations and treatment assessment for scrotal, testicular and prostate conditions.
Doctor profileurologist
Urologist conducting consultations for patients with testicular, scrotal, penile, prostate and urinary tract conditions.
Doctor profileDo you have scrotal swelling or suspect a hydrocele?
Book a urological consultation. The doctor will assess the lesion, perform or arrange a scrotal ultrasound and discuss possible treatment options.
Frequently asked questions about hydrocele
Is a hydrocele dangerous?
A hydrocele itself is often a benign condition, but scrotal swelling always requires medical assessment — an inguinal hernia, inflammation, testicular torsion or testicular tumour can all look similar. The diagnosis is made by the doctor after examination and ultrasound.
Does a hydrocele hurt?
A hydrocele most often causes scrotal swelling without severe pain — the patient may feel heaviness or discomfort. Sudden, severe pain is not typical for a simple hydrocele and requires urgent medical assessment.
Does a hydrocele always need surgery?
Not always. A small, asymptomatic hydrocele may be kept under observation. A large, growing hydrocele or one that causes significant discomfort may require surgical treatment. The urologist assesses candidacy after examination and ultrasound.
Is needle aspiration enough?
Aspiration removes the fluid and may temporarily reduce the scrotum, but in many patients the fluid reaccumulates. Aspiration is not always a definitive treatment. The choice of method is decided by the urologist after examination and ultrasound.
What test best confirms a hydrocele?
The basis is a urological examination. The doctor will often also arrange a scrotal ultrasound, which confirms the presence of fluid and distinguishes a hydrocele from other causes of scrotal swelling — cyst, varicocele, epididymitis and testicular tumour.
Can a hydrocele conceal a tumour?
A large hydrocele may make it difficult to examine the testicle thoroughly by palpation, which is why ultrasound is particularly important. Any swelling, hard lump or change in the consistency of the testicle requires urgent urological assessment.
Why should you not delay a consultation?
A hydrocele is often a benign condition, but "scrotal swelling" is not a diagnosis. Until the doctor examines the patient and assesses the scrotum on ultrasound, it is not possible to confidently exclude a hernia, inflammation, cyst, varicocele, testicular torsion or tumour.
What patients say after their consultation
★★★★★ 5.0 · ZnanyLekarz
"I had noticed the swelling a few weeks earlier but kept putting the appointment off. I finally came in — the doctor calmly explained what it was, ordered an ultrasound, and I had a clear answer straight away. Professional, no unnecessary alarm."
Marek S. · ZnanyLekarz"I was afraid it was something serious. The doctor examined me and arranged an ultrasound — it turned out to be a hydrocele. The explanation was clear, and I had time to ask questions. Glad I came and didn't keep waiting."
Tomasz W. · ZnanyLekarz"I had the scrotal ultrasound after the consultation. Fast, efficient, result discussed on the spot. I recommend it to anyone who doesn't know what's going on and needs a concrete answer without waiting."
Piotr K. · ZnanyLekarzRead more — scrotal diagnostics and urology
Assessment of the scrotum, testicles, prostate and urinary tract.
See service →Scrotal scan — testicle, epididymis, fluid, varicocele, cysts.
See service →Consultation and ultrasound costs at Wyspa Medycyny Przyjaznej.
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Wyspa Medycyny Przyjaznej — ul. Toruńska 15 lok. AU1, Gdańsk. Mon–Fri 9:00–20:00.
The information on this page is for educational purposes only and does not constitute medical advice. Every case requires individual assessment by a qualified physician. Wyspa Medycyny Przyjaznej Sp. z o.o., ul. Toruńska 15 lok. AU1, Gdańsk.