Water in the testicle


Hydrocele, water break


Under the term "Hydrocele“(Water in the testicle) one understands one Accumulation of fluid within the Scrotum (scrotum). It is mostly one benign Changes in the testicles that usually do not cause pain in the person affected. The water in the testicles can purely on the Testicles be limited (Hydrocele testis) or additionally the Spermatic cord affect (Hydrocele funiculi spermatici).


In a baby, water appears in the testicle when the abdominal wall is not completely closed during embryonic development after the testicle descends from the abdomen into the scrotum.

The water in the testicles is mostly one benign and painless change in the area of Testiclewhere it is too pronounced Build-up of fluid within the scrotum comes. In most cases, the water can build up in the testicle spontaneous regress without medical intervention.

If the hydrocele does not regress by itself in an affected person, the change should be made operational be treated. The forecast when water in the testicle is generally considered very good to watch. If there is water in the testicle, you have to choose between one innate and one acquired Distinguish progressive form.

The innate Water in the testicle (synonym: primary water break) occurs at infant especially when the Abdominal wall not completely closed during embryonic development has been. In Germany, around one to seven out of 100 newborn boys have water in their testicles. The risk of the primary occurrence of this change is therefore approximately 1 to 7 percent.

The so-called secondary (acquired) Water in the testicles, on the other hand, only occurs in childhood or adulthood. The causes for the development of an acquired hydrocele can be very diverse. Especially inflammatory processes in the area of ​​the testicles or epididymis seem to play a crucial role in this context. Typical signs that indicate the presence of water in the testicles are unilateral swelling in the area of ​​the scrotum such as Feelings of pressure and heaviness. Already at Suspicion the presence of water in the testicles must urgently promptly Specialist to be visited. This is the only way to assess the course of the change and (if necessary) to initiate appropriate treatment quickly.


The causes for the accumulation of water in the testicles can be many. In addition, when looking for the cause, a distinction must be made whether it is a innate or acquired Hydrocele acts.

Congenital hydrocele

The congenital (primary) water rupture arises from the fact that during the embryonic development Fluid in a funnel-shaped protuberance on the peritoneum accumulates in the area of ​​the abdomen of the unborn child. It is precisely this protuberance that represents the transition from the peritoneum to the child's scrotum. Normally, the protuberance develops completely back within the womb with the exception of a remnant. In addition, it must be noted in this context that the Testicles during the development of the fetus not in the scrotum but rather mature in the abdomen. Only a short time before the birthShortly after the birth, the testicles descend from the abdominal cavity into the scrotum. During this descent, the testicles slide down into the scrotum through the funnel-shaped protuberance just mentioned. The connection to the actual peritoneum should then close. Primary water in the testes forms when the seal to the peritoneum is not or only to a small extent. Children who suffer from congenital water in the testicles often also tend to have a so-called Inguinal hernia to develop.

Secondary hydrocele

However, the build up of water in the testicle can also have acquired causes (secondary water break). The typical causes of water retention in the testicles in older boys or adults are:

  • inflammatory processes in the area of ​​the testicle or epididymis

  • Injury or violence

  • Ulcers (tumors) of the testicle

In addition, it can often be observed that water accumulates in the testicles after an operation on the scrotum. In general, it can be assumed that secondary water rupture leads to the formation of an imbalance between the testicular membrane fluid that is formed and that is absorbed. The affected person's body either produces too much testicular fluid or is unable to absorb enough fluid.

You might also be interested in: Scrotum


Ultrasound examination, magnetic resonance tomography or diaphanoscopy are suitable imaging methods.

The diagnosis of suspected presence of water in the testes is divided into several steps. First, during a detailed doctor-patient conversation (anamnese) determines which complaints are present in the affected patient. Also the temporal course the disease, possible Pre-existing illness and complaints, which often occur in the family of the person concerned, play a decisive role in the diagnosis of water in the testicles. Especially Tumor diseases of Testicle can be common within the family and be a cause of water buildup in the testicles.

This doctor-patient interview is usually followed by a orientational physical examination. Here gropes the doctor removes the scrotum and checks whether there are any changes in the scrotum area. If there is a water break, the testicle is usually swollen on one side (in rare cases also on both sides).

If the presence of water in the testicles is suspected, it is urgent imaging procedures connected. Especially the Ultrasound examination (Sonography) of the testicle plays a crucial role in the diagnosis of water in the testicles. In addition, the implementation of a Magnetic resonance imaging be useful if there is water in the testicles. In addition, the so-called Diaphanoscopy help to identify the water break as such. In this procedure the doctor examines the scrotum with a powerful lamp. If water has accumulated in the testicle, lighter areas will show up when x-rayed. The problem with this examination method, however, is that the x-ray of the scrotum cannot help distinguish a water hernia from an inguinal hernia.

You can read more information on this topic here: Ultrasound of the testicle


The symptoms of a buildup of water in the testicle can vary widely. The affected patients usually quickly develop visible swellings in the area of ​​the scrotum (scrotum). Depending on the cause of the water break, this swelling can be on one or both sides. How much the testicle is swollen depends mainly on where the water is in the testicle and how much fluid is in the scrotum. Especially in the early stages, the water in the testicles often does not cause any discomfort. With increasing accumulation of fluid within the scrotum, however, severe discomfort can occur. People who have water in their testicles typically experience pain and a marked feeling of pressure or heaviness.

The so-called acute water break is a special form of the hydrocele. This clinical picture typically results in an acute scrotum. This means that the affected patients suffer from sudden, severe pain in the area of ​​the testicles.

For more information, see: Pain testicles and Swollen testicles - what's behind it?


If water accumulates in the testicles, therapy is primarily geared towards the underlying cause. In addition, the symptoms experienced by the affected patient play a crucial role in choosing the most appropriate treatment strategy.

Primary water break

In the case of a congenital water break, the first step is usually no treatment be initiated. The reason for this is the fact that there is a congenital water break mostly completely harmless is and yourself completely resolves within a few weeks without medical intervention.

However, it should be next to the water in the testicles additionally an inguinal hernia exist, so a surgical intervention is necessary immediately become. The pure water break, however, is mostly observed first.

Should the water in the testicles not regress within the first few years of life or the hydrocele further increase in volumeso is the introduction of a surgical therapy makes sense. During the operation, the attending physician must remove the water breach small cut in the groin expose and the Seal the connection between the abdomen and scrotum.

Acquired water break

If the hydrocele (water in the testes) does not regress or even increases in volume, the water break should be treated surgically.

Collects first after birth If there is water in the testicle, the primary aim of treatment should be to correct the cause of this change. Once the cause has been treated, the water forms in the Testicles mostly completely by itself. However, if the water remains in the testicles, the water break should be exposed in a surgical procedure drain excess fluid and excess testicular skin removed. In adult men who have water in their testicles, the accumulated fluid can also aspirated through a cannula become.


The prognosis for water in the testicle is usually very good. The changes associated with the build-up of fluid within the scrotum are in most cases benign.

Primary water that occurs in the testicles is usually formed completely back without medical intervention. Consequential damage must not be assumed in the case of congenital water rupture.

At acquired Water in the testicles (secondary water breakage) it is usually sufficient treat the underlying cause. If the water in the testicle does not recede, a operative treatment be useful. Even after surgical correction of the water break, the prognosis is very good. Consequential damage or the recurrence of fluid accumulations in the scrotum (so-called recurrence) must not be expected with the usual surgical procedures.

Prevention (prevention)

So far are no measures knownthat can help safely prevent water from building up in the testicles.

However, the risk of developing an acquired water break can be reduced slightly. The most important measure in preventing water buildup in the testicle is that consistent treatment of possible triggers. Play in this context inflammatory Processes in the area of ​​the testicles and Epididymis a crucial role. In addition, should Injuries and / or violence be prevented in the genital area through adequate protection, for example when performing high-risk sports.

The creation of a primary, already before the birth water breakage can occur Not be prevented.