There are two main types of hydrocele:
1. Communicating Hydrocele:
o This type occurs when there is a persistent connection between the abdominal cavity and the scrotum via the processus vaginalis (a channel that is supposed to close after birth).
o In newborns, this connection sometimes does not close properly, leading to a hydrocele. The sac may contain fluid from the abdominal cavity.
o A communicating hydrocele can fluctuate in size and might change with body position or in response to pressure changes.
2. Non-communicating Hydrocele:
o This type occurs when the connection between the abdominal cavity and the scrotum is closed off (typically after birth) but fluid still accumulates in the sac around the testicle.
o The fluid typically does not fluctuate in size and remains relatively stable.
o This is the more common type in adults.

1. In Infants:
o Congenital hydrocele: The most common cause of hydrocele in newborns is the incomplete closure of the processus vaginalis during fetal development. This allows fluid from the abdomen to enter the scrotum, leading to a hydrocele.
o In many cases, congenital hydroceles resolve on their own within the first year of life as the processus vaginalis closes.
2. In Adults:
o Injury or trauma: Any injury to the scrotum or testicles can lead to a buildup of fluid.
o Infection: Infections such as epididymitis (inflammation of the epididymis) or orchitis (inflammation of the testicle) can cause a hydrocele to form as a result of the body’s inflammatory response.
o Hernia: A hydrocele can sometimes occur alongside an inguinal hernia, as fluid from the abdominal cavity can enter the scrotum.
o Tumors: Although rare, testicular tumors or other growths can block the drainage of fluid, leading to the formation of a hydrocele.
o Chronic inflammation or infection: Long-term conditions, such as tuberculosis or sexually transmitted infections (STIs), can also lead to the development of a hydrocele.

The primary symptom of a hydrocele is swelling in the scrotum, which may vary in size depending on the type of hydrocele. Specific symptoms include:
• Painless swelling: A hydrocele usually presents as a soft, painless swelling in one or both sides of the scrotum. The swelling may be more noticeable in the morning or after standing for a long time.
• Discomfort: Some men may feel a sensation of heaviness or fullness in the scrotum, especially if the hydrocele is large.
• Size fluctuations: In communicating hydroceles, the swelling may change in size or even disappear when lying down, as the fluid moves back into the abdomen.
• Tightness: In severe cases, the scrotum may feel tight or stretched.

A hydrocele can often be diagnosed through a physical examination and a few simple tests. These include:
1. Physical Examination:
o The doctor will examine the scrotum and testicles, feeling for any abnormal swelling or fluid accumulation.
o They may gently shine a light through the scrotum in a procedure called transillumination. A hydrocele will typically allow light to pass through, helping to distinguish it from other conditions like testicular tumors.
2. Ultrasound:
o If the diagnosis is unclear or if the doctor suspects another underlying condition (such as a tumor or hernia), an ultrasound of the scrotum may be recommended. This non-invasive imaging test uses sound waves to create a detailed picture of the testicles and surrounding tissues, helping to confirm the presence of fluid and rule out other issues.