Hydroceles and inguinal hernias are common surgical problems that can occur at any age. A hernia is suspected when a child has a "bulge" in the groin or in boys only, the scrotum. Inguinal hernias are much more common in boys. A hernia is the descent of abdominal contents into the groin or scrotum. In boys, the contents may include the intestines. In girls, the contents may include the intestines, fallopian tubes and ovaries. A hydrocele is a collection of fluid in the scrotum around the testicle.
A passage between the abdomen and the groin called the tunica vaginalis normally closes during the last trimester of pregnancy. When this passage does not close, a hernia or hydrocele can result. A communicating hydrocele or hernia always means that the passage is open and that surgery is needed to close the passage.
Small scrotal hydroceles are common at birth. This is due to the trauma of the delivery. This type is called a noncommunicating hydrocele and will resolve on its own.
Show AllWhen a hydrocele is present, a nontender mass or bulge is seen in the groin or scrotum. A communicating hydrocele or hernia will change in size, becoming larger when a baby is crying or if older, when the child is up walking. The bulge will decrease in size when the child is sleeping or quiet. A hydrocele or hernia is in general not painful, however, some infants do experience pain. They exhibit this by excessive irritability, crying, and pulling the legs up to the abdomen.
A hydrocele does not pose a serious risk, but it can develop into a hernia. As long as the abdominal contents can be eased back into the abdomen, the child is not at risk. If, however, the abdominal contents become stuck and cannot be reduced (pushed back) into the abdomen, it is termed an incarcerated hernia. If your child develops vomiting, extreme tenderness of the area, a black and blue appearance to the groin or scrotum, fever, or diarrhea, the hernia may have become incarcerated. This can result in a bowel obstruction or damage to the contents in the hernia.
Observation will be the treatment for a noncommunicating hydrocele. If a communicating hydrocele or hernia is present, surgery will be needed.
After Surgery Care
After surgical repair of a hernia / hydrocele, a special dressing will be placed over the incision. This may be a clear painted on sealant or some fabric strips, called Steri-Strips. These will gradually work their way loose and peel off. The area should be kept as clean and dry as possible with frequent diaper changes. If BM gets on the wound, clean it as well as you can with a warm wet washcloth.
Additionally, please follow these limitations:
- No tub baths until 5 days post-op
- No straddle toys or playing in sandboxes for 4 weeks
- No gym, sports, lifting more that the weight of a gallon of milk for 4 weeks
- May return to school 2-3 days post-operatively or when no longer taking narcotics for pain control
Call your doctor if your child is excessively irritable, seems to be in pain, vomits, has fever or diarrhea. These symptoms should be reported immediately.
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
