Communicating Hydrocele (Hernia)

What is a communicating hydrocele (hernia)?

A communicating hydrocele is a collection of fluid that is in the scrotum, surrounding the testicle. In children, a communicating hydrocele is the same thing as a hernia. This can occur because the testicles develop in the abdomen and drop into the scrotum over time. As the testicles descend they bring a lining of the abdomen down with them as a tube.  In most boys, this tube will close. However, if it stays open fluid and possibly intestine can move freely between the scrotum and abdomen.

What are signs/symptoms of a communicating hydrocele/hernia?

The scrotum can become very large and then small. These fluctuations in size are usually visible throughout the day. The scrotum may be largest when you child is crying or straining. The swelling is generally not painful if only filled with fluid. If intestine gets trapped inside the tunnel, the scrotum can become very painful, red and firm. Your child may become very fussy if this occurs.

 What causes a communicating hydrocele/hernia?

This can occur because the testicles develop in the abdomen and drop into the scrotum over time. As the testicles descend they bring a lining of the abdomen down with them as a tube. In most boys, this tube will close. However, if it stays open fluid and possibly intestine can move freely between the scrotum and abdomen.

How is a communicating hydrocele/hernia diagnosed?

A communicating hydrocele/hernia is diagnosed on physical exam and by talking to the family about changes in size of the scrotum.

How is communicating  hydrocele/hernia treated?

The problem can be corrected by a surgery that includes a small incision in the groin. The connection (tunnel) is located and closed off so that fluid and intestine can no longer travel down to the scrotum.  This surgery can be performed electively. However, if the scrotum becomes firm, red or painful then you should bring your child to the emergency room for urgent evaluation.