Congenital Hydrocele - Treatment Overview

Treatment Overview

For a congenital hydrocele that remains the same size or gets smaller (a noncommunicating hydrocele), aggressive treatment is not recommended. A noncommunicating hydrocele generally will go away by age 2. The focus will be on watching the hydrocele for any changes.

However, surgery generally is necessary if a noncommunicating hydrocele:

• Does not go away by age 2.
• Comes and goes.
• Feels firm.

If your child has a hydrocele that varies in size (a communicating hydrocele), surgery generally is necessary.

When surgery is necessary, your child first receives general anesthesia. A small incision is made in the groin area, and the sac containing the hydrocele is identified. The surgeon empties the fluid from the sac and ties off the sac to close it. Stitches are then used to strengthen the area and prevent another hydrocele from forming.

One of the major decisions in surgery for hydrocele is whether to explore the opposite groin area for an inguinal hernia or another hydrocele during the surgery. At this time, there is no agreement as to the age at which this should be considered.² But the older your child is, the less likely it is that the other side will be explored.

Removal of the fluid with a needle (aspiration) is not performed on children because of the high risk that the hydrocele will return or become infected.