Understanding Hydroceles: The Watery Woe of Many Men

Dr Koh Li-Tsa Urologist Urohealth Hydrocele

Imagine having a collection of fluid within the male scrotum. This condition actually happens to a lot of newborns, but it can happen to some adults too! The term for this condition is Hydrocele.

Let’s shed light on its causes, symptoms, and treatments. We learn more about it with Dr Koh Li-Tsa. Dr Koh Li-Tsa is a Senior Consultant Urology with Urohealth Medical Clinic. She specialises in the treatment of urinary incontinence, overactive bladder, nocturia, urinary stones, urinary tract infections, bladder and prostate diseases as well as men’s health issues.

What is a Hydrocele?

Dr Koh explains that “A hydrocele is a collection of fluid inside the scrotum of a male. This fluid surrounds the testis and is contained within a lining called tunica vaginalis. Hydroceles usually occur on one side of the scrotum but can be present on both sides. It is usually painless and may feel fluctuant. The swelling will be transilluminable which means that the fluid in the hydrocele would light up when a torch is shone directly on the scrotum.”

How Does It Happen?

The causes of hydroceles vary, but Dr Koh gives a primary reason for adults and children, respectively. She explained, “In adults, a hydrocele may form as a result of injury or inflammation of the testis. Hydroceles are quite common in newborns but will usually spontaneously resolve by the first year of life.”

Symptoms to Look Out For

  • Visible swelling. One side of the scrotum may look bigger.
  • Discomfort. Although generally painless, large hydroceles can be uncomfortable.
  • Pressure. Some men feel heaviness or dragging sensation.

Remember, if there’s sudden or severe pain, see a doctor immediately.


Physical exam: It’s the first step. Dr Koh also stated that “A hydrocele can be detected on physical examination. Doctors usually perform an ultrasound examination to rule out other causes like testicular tumours and hernias.”


Not all need to be treated. “If the hydrocele is small, painless, not enlarging and not bothering the patient, it is reasonable to observe the hydrocele and leave it alone. Should the patient be bothered by any of the aforementioned symptoms, he can choose to undergo a small surgery to remove the hydrocele”, Dr Koh explained.

However, she warned that “Hydroceles may bleed or get infected. In rare cases, the pressure of the hydrocele fluid on the testis may affect fertility or may cause the affected testis to shrink.” You should see a doctor if that happens. 

Living With The Condition

Most hydroceles are harmless. Visible swelling, especially its emotional impact, shouldn’t go unnoticed. Open conversations and seeking medical advice can help manage and treat this condition.

In Conclusion

Although common, it often remains under the radar due to the silence surrounding men’s reproductive health issues. Early detection and treatment can make a significant difference in a man’s quality of life. It’s crucial to prioritise health, break taboos, and seek timely medical intervention.

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