Is surgery needed if a testicle swells when the baby cries?

Question

Hello Doctor,

Recently, we noticed that one side of my son's testicle becomes enlarged when he cries. As per the pediatrician's advice, we took an ultrasound scan (ultrasonography) for the baby. Please check the report and let me know if surgery is required for the baby.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on the information you provided and the ultrasound prescription (attachment removed to protect the patient’s identity), the child is likely suffering from a congenital communicating hydrocele or possibly an inguinal hernia. The main clinical sign you mentioned, "one side of the scrotum gets enlarged when the baby cries," strongly supports the possibility of a communicating hydrocele or hernia. This happens when the processus vaginalis (a small channel between the abdomen and the scrotum) remains open after birth. When the baby cries or strains, the pressure inside the abdomen pushes fluid or even a part of the intestine into the scrotum, causing swelling. This is a common condition in infants, and the swelling is usually soft and painless.

To confirm the condition, a detailed ultrasound scan of the scrotum is needed to determine whether it is a hydrocele or a hernia and whether any bowel loops are entering the scrotal sac. A clinical examination by a pediatric surgeon is also very important.

The possible diagnoses are a communicating hydrocele, an inguinal hernia, or a non-communicating hydrocele (though this is less likely because the swelling size changes). If confirmed, surgery is advised. This is a routine pediatric procedure performed under general anesthesia. It is usually done after the baby is three months old, but it can be done earlier if there are complications such as painful or irreducible swelling.

For follow-up, if the swelling becomes hard, painful, or red, or if the baby starts vomiting or crying continuously, immediate medical attention is necessary, as this could be a sign of a strangulated hernia. Otherwise, regular follow-up with a pediatric surgeon is recommended. There are no specific preventive measures, as this is a congenital (present from birth) condition.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

The ultrasound report you shared shows a communicating hydrocele, which means there is fluid in the right side of the scrotum, in simple terms. You need to consult a pediatric surgeon for this condition so that the fluid can be removed through surgery.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.