L'hydrocèle chez l'homme adulte : Pourquoi cela arrive-t-il ?

Dernière mise à jour : 18 mai 2026

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A painless scrotal swelling is one of the most common presentations in my andrology clinic. The condition we must always be aware of is a Hydrocele — an abnormal accumulation of fluid within the scrotal sac surrounding the testicle.

• Centre d'urologie Hôpital de Bangkok Thaïlande Réservation en ligne 02-310-3009 bhquro@bdms.co.th
• Hôpital Samitivej Sriracha Chonburi 088-022-1445

To understand why hydrocele occurs, a brief review of scrotal anatomy is helpful. Between the scrotal skin and the testicle lies a space covered by a layer called the Tunica vaginalis, which contains a small amount of fluid that allows the testicle to move freely. This space has a balanced system of fluid production and absorption. When this equilibrium is disrupted — either through overproduction or reduced absorption — fluid accumulates, creating a hydrocele.

2 major causes of Hydrocele in adult men

1. Overproduction of fluid:
   • Inflammatory processes — infection of the testis (orchitis) or epididymis (epididymitis), or syphilis
   • Trauma — scrotal injury, or as a complication after inguinal hernia repair
   • Malignancy — tumor in or around the genital area
2. Abnormal fluid absorption — failure of the Tunica vaginalis to reabsorb fluid at the normal rate

When a patient presents with a scrotal swelling, a full history is taken and a careful physical examination performed to exclude other important diagnoses that may appear similar:

• Hernie inguinale
• Epididymo-orchitis (infection of the testicle and epididymis)
• Tumeur testiculaire

Scrotal ultrasonography is the gold standard imaging tool for confirming hydrocele. It measures the fluid size and characteristics, and — critically — it can confirm whether any suspicious testicular tumor is hidden within the sac.

Once hydrocele is confirmed, treatment targets the underlying cause. If the hydrocele does not resolve after treating the cause, surgical intervention is offered. Two surgical techniques are available:

1. Open scrotal surgery — performed in the operating room under anesthesia; lowest postoperative complication and recurrence rate; the preferred definitive treatment
2. Needle aspiration — an in-office option for patients who decline surgery; however, carries higher risk of intra-scrotal bleeding and a higher recurrence rate compared to surgery

The key message is that hydrocele is a benign condition — it is never life-threatening, but it can significantly affect quality of life. Surgery is the most effective treatment, though some recurrence remains possible with any approach.

Frequently Asked Questions About Hydrocele

What is a hydrocele and is it dangerous?

A hydrocele is an abnormal accumulation of fluid in the space between the testicle and the inner scrotal wall (Tunica vaginalis), causing painless scrotal swelling. It is a benign condition — it is never life-threatening and does not become cancerous. However, a large hydrocele can cause discomfort, heaviness, and reduced quality of life. The most important first step is scrotal ultrasound to confirm the diagnosis and exclude hidden testicular tumor, which can occasionally present similarly.

What causes hydrocele in adult men?

In adult men, hydrocele is caused by either overproduction of scrotal fluid or impaired fluid absorption. Overproduction occurs secondary to inflammation (testicular or epididymal infection, syphilis), scrotal trauma, hernia repair complications, or nearby malignancy. Impaired absorption occurs when the Tunica vaginalis lining loses its ability to reabsorb fluid at the normal rate. Many adult hydroceles develop gradually without a clearly identifiable trigger and are classified as idiopathic. A thorough evaluation is essential to exclude treatable secondary causes.

When is surgery needed for hydrocele and what are the options?

Surgery is indicated when the hydrocele does not resolve after addressing the underlying cause, or when it causes significant discomfort. Open scrotal surgery (hydrocelectomy) performed under anesthesia in the operating room offers the lowest complication and recurrence rates and is the gold standard approach. Needle aspiration is an in-office alternative for patients who prefer to avoid surgery, but carries higher rates of intra-scrotal bleeding and recurrence. After surgery, regular follow-up is recommended to monitor for recurrence.

If you have a scrotal swelling and would like specialist evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Prendre rendez-vous.

Avis de non-responsabilité : Ce contenu est rédigé et revu par le Dr Soarawee Weerasopone, urologue certifié au siège de Bangkok Hospital. Il est destiné uniquement à des fins éducatives et ne constitue pas un avis médical. Consultez toujours un professionnel de la santé qualifié avant de commencer tout traitement médical.