Paediatric Urology – Fluid Hernia in children

A fluid hernia (communicating hydrocele) is a collection of fluid surrounding the testicles and is a condition most commonly affecting infant boys.

In many cases it will spontaneously disappear as the baby gets older. Occasionally, a fluid hernia may persist and require treatment. A child with a fluid hernia will be noted to have a painless swelling in the scrotum – the swelling is typically small when the child wakes up in the morning and enlarges during the course of the day.
Most of the time only one side of the scrotum is affected.

1What causes a fluid hernia?

A fluid hernia is a remnant of normal development in the scrotum of boys. It consists of fluid, which communicates with the abdominal space via a canal in the groin of the child. In some children the groin canal will close on its own a few months after birth and the fluid hernia will then disappear.

If it hasn’t disappeared by about 18 months of age, surgical correction is required.

2What are the options for treatment of a fluid hernia?

Most fluid hernias disappear spontaneously as the child grows and do not need any treatment. In the vast majority of patients it is not painful for the baby and will not cause any problems or complications.
Therefore conservative management is advised and the fluid hernia is left alone.

In the case of very large swellings or where the child is older than 18 months, your doctor may recommend surgical correction to repair the fluid hernia.

3What to expect during fluid hernia surgery

Your child will likely require admission to hospital for at least 1 day. Surgical repair of a fluid hernia is performed with the child under general anesthesia. A small incision is made in the groin and the abnormal canal allowing fluid from the abdominal space to reach the scrotum is closed. It is a minor surgical procedure and the duration is usually less than 1 hour.

4What are the risks and complications of fluid hernia surgery?

Fluid hernia repair is generally a safe procedure and complications are very uncommon.

Possible complications include:

  • Bleeding
  • Infection at the site of repair
  • Altered sensation on the skin around the scrotum
  • Damage to testicle on the same side