The testes sit inside a sac in the scrotum, bathed in a small amount of body fluid to facilitate their free movement. A hydrocoele is an excessive collection of this fluid around the testis – causing an obvious swelling in the scrotum. Hydrocoeles are usually painless and present no risk to a man’s health.

What causes a hydrocoele?

Hydrocoeles most commonly occur in men aged over 40 years.

In most men the exact cause is unknown – this is referred to as idiopathic.

Occasionally there is a problem with one of the testes, which results in the formation of the excess fluid. Some of the conditions that can result in a secondary hydrocoele include:

  • Tumour.

  • Infection.

  • Trauma.

  • Inflammation.

How are hydrocoeles treated?

The majority of hydrocoeles require no treatment at all. They are painless and present no threat to a man’s health. You might consider treatment in the following circumstances:

  • It becomes uncomfortable in different positions or activities.

  • It becomes embarrassing or unslightly because of its size.

  • It becomes infected.

  • You would just prefer it gone.

If you do need treatment the options are:


This is a day procedure in which a small incision is made in the scrotum, the fluid drained and measures taken to minimise the chance of recurrence. Learn about Hydrocele Repair.


The fluid can be drained from a hydrocele. This can be done in the office or outpatient department without an anaesthetic. A needle is passed into the scrotum and the fluid drained. It is not usually a good option as the fluid re-accumulates in the vast majority of cases within quite a short time. It is a reasonable option is quick short term reversal of the swelling is required.