What is a communicating hydrocele? In the communicating hydrocele, the passage of the abdominal fluid occurs through the opening left by the descent of the testicles from the abdominal cavity during the development of the fetus, as a result of which swelling of the scrotal sac occurs. How serious is a communicating hydrocele? A communicating hydrocele is a more serious condition than a non-communicating hydrocele. A non-communicating hydrocele usually stays the same size or has very slow growth. A communicating hydrocele can change in size during the day. It can increase significantly and cause discomfort. What happens if a communicating hydrocele is not treated? If a communicating hydrocele does not go away on its own or is left untreated, it can cause an inguinal hernia. In an inguinal hernia, part of the intestine or intestinal fat is pushed through an opening (inguinal canal) in the groin area. Communicating hydrocele affects newborn male infants, however, the defect can also develop in adolescent and adult males, usually with a hernia. Cases of communicating hydrocele are very common. Nearly 50% of all newborn boys have a communicating hydrocele, but the defects usually disappear on their own without treatment by about 12 months of age. A communicating hydrocele usually does not cause pain. However, swelling may be noticed on one side of the scrotum. Swelling may decrease with lying down and may increase with activity. In older children, a communicating hydrocele may indicate other problems, such as infection, testicular torsion (torsion), or a tumor. In newborns, communicating hydrocele often improves without treatment within a year. If it does not improve on its own, a hydrocelectomy may be needed. What are the symptoms of a communicating hydrocele? With a communicating hydrocele, complaints may include: Swollen or enlarged scrotum; Swelling that waxes and wanes throughout the day; In addition to these complaints, in older children and adults, symptoms may also include: Inflammation; Discomfort as the scrotum swells and becomes heavy; Pain when the size of the scrotum increases. References: 1. Koski ME, Makari JH, Adams MC, et al. Infant Communicating Hydroceles�Do They Need Immediate Repair or Might Some Clinically Resolve 2. National Library of Medicine. Hydroceles 3. Urology Care Foundation. What are Hydroceles and Inguinal Hernias