This is fluid within the processus vaginalis within the scrotum.

Clinical features

  • Swelling in the scrotal sac that may spread down from the inguinal canal, in the communicating type, or remain localized to the scrotum in the non-communicating type.
  • Communicating types are associated with straining and may develop strangulation if bowel contents enter.
  • In non communication type, one can palpate and grasp the sac towards the scrotum and get above it.


  • Trans-illumination test is positive
  • Communicating type demonstrated on straining


  • Communicating hydrocele (or inguinoscrotal hernia with no bowel content) will not close spontaneously and surgery is indicated. This type has a high risk of incarceration.
  • Observe infants presenting with non communicating hydrocele, as often these will resolve on their own as the hydrocoel fluid is slowly reabsorbed. The only indications for surgery are: failure to resolve by 2 years, cause discomfort, become infected, or show variations is size.