Tests and diagnosis
By Mayo Clinic staffYour doctor will do a physical exam. The exam may reveal an enlarged scrotum that isn't tender to the touch. Pressure to the abdomen or scrotum may enlarge or shrink the fluid-filled sac, which may indicate an associated inguinal hernia.
Because the fluid in a hydrocele usually is clear, your doctor may shine a light through the scrotum (transillumination). With a hydrocele, the light will outline the testicle, indicating that clear fluid surrounds it.
If your doctor suspects your hydrocele is caused by inflammation, blood and urine tests may help determine whether you have an infection, such as epididymitis.
The fluid surrounding the testicle may keep the testicle from being felt. In that case, you may need an ultrasound imaging test. This test, which uses high-frequency sound waves to create images of structures inside your body, can rule out a hernia, testicular tumor or other cause of scrotal swelling.
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- Hydroceles and inguinal hernias. American Urological Association. http://www.urologyhealth.org/urology/index.cfm?article=129. Accessed Sept. 17, 2011.
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- Hydrocele. National Guideline Clearinghouse. http://www.guideline.gov/content.aspx?id=12592. Accessed Sept. 17, 2011.
- Painless scrotal mass. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/symptoms_of_genitourinary_disorders/painless_scrotal_mass.html. Accessed Sept. 17, 2011.
- Cimador M, et al. Management of hydrocele in adolescent patients. Nature Reviews Urology. 2010;7:379.


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