Children's Hospital Colorado
Urology

Inguinal Hernia and Hydrocele

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What is an inguinal hernia and hydrocele?

When a boy is developing, the testicles begin in the belly and travel down the abdomen and through the inguinal canal. As they do this, they bring with them part of the lining of the abdomen, which is called the processus vaginalis. The processus vaginalis creates an opening from the abdomen, down to the scrotum, where the testicles eventually settle. Once in the scrotum, the opening (processus vaginalis) typically closes. If the opening does not close properly, tissue or liquid can move from the abdomen into the scrotum, which causes an inguinal hernia or a hydrocele.

Inguinal hernias and hydroceles are both characterized by swelling of the groin and scrotum (testicle sac). The swelling can also extend into the groin (the inner area of the hip between the stomach and the thigh).

If the opening left by the processus vaginalis is small, only fluid can pass through, and the swelling this creates in the scrotum is called a hydrocele, or a non-communicating hydrocele. However, if the opening is large enough, a part of the intestine can move into the scrotum and this is called an inguinal hernia or communicating hydrocele. Learn how our doctors repair a hernia.

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What causes inguinal hernia and hydrocele?

Hernias and hydroceles in children are usually congenital, meaning they are present at birth. The hernia or hydrocele sac occurs when the opening left by the processus vaginalis allows fluid or part of the intestine into the scrotum. The opening should normally close on its own during development, but it remains open in some people. When the opening to the sac is wide, parts of the abdomen (bowel and fat) can enter the sac and make it become an inguinal hernia. If the opening is only wide enough to let in fluid, this creates a hydrocele.

Who gets hernias and hydroceles?

Hernias and hydroceles occur in about 1 out of 100 boys and hernias occur less commonly in girls. They are also more common in children who are born prematurely and in children with a family history of these conditions.

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