How to Deal with Hydroceles and Hernias in Children

Host: Some babies are born and the physician notice that the area has got blown up, he puts the leg up, he sees this fluid. Is this term hydroceles? Steven Friedman: It's very common for newborn boys to have scrotal swelling when they are born, these are called hydroceles. Usually testicle area is surrounded by fluid. If you can shine a light through this, and it glows, and there is no sign of hernia, this can be observed in that 90% of these are out by one year of age. This means that there is a little communication between the belly and the scrotum, and it allows fluid to exchange from the abdominal cavity through the scrotum. As a child becomes older, by the age of one, the scrotum usually, slowly would be -- fluids usually slowly resolves. However, what parents can see, and I try to tell them that this is not alarming, is that the scrotum can change size throughout the first few months of life. There can be days when the scrotum is very small and other days where its large, filled with fluid. As long as its fluid and not a hernia, it is safe, and no treatment or no emergency intervention is necessary. Host: Parents should be aware that the testicles aren't always the same; one is a little high and one is a little low. Is that true? Steven Friedman: Yeah, that is very common. As long as the testicle is within the scrotal sack, it should develop well. Host: If you have a hydroceles, do you have a greater risk towards getting a hernia? Steven Friedman: If the hydrocele is still present after a year of age, there is an increase incidence of hernias developing. Therefore if the hydrocele is still present in one year, we do recommend surgical intervention to correct it, to prevent a future possibility of hernia development. Host: If the kid is crying, and they look down, and they are not sure, there is a lump down there, there is a thing called inguinal hernia? Steven Friedman: What's important point is to differentiate a hydrocele from a inguinal hernia. The hydrocele usually is just fluid within the scrotal sack. However, if a baby cries and you see swelling or a walnut size growth or bulb in the inguinal or groin area, that's usually a sign of a hernia, and that has to be taken care of immediately. Hernias can strangulate or incarcerate, and that would require emergency surgery. Host: Sometimes it could be pushed back, and they may watch it for a little bit, is that true? Steven Friedman: If the bump or that lump can be pushed back, then usually you try to relax the child, put him in the bed, push the area back. If it does go back in, then the emergency is over, but the hernia should be dealt with within next several weeks to be -- Host: But if you see a lump, the kid is in pain, you do not wait casually to see a doctor the next day. Steven Friedman: Yeah, if the lump cannot be pushed back after several attempts, the doctor should be contacted immediately, absolutely. Host: Sometimes girls get a thing called a femoral hernia, and occasionally you see an ovary in that area? Steven Friedman: Yes, hernias do occur in females or girls, and is much less common than in boys. However, it's much more concerning. When girls get a hernia, in ovaries, there is a bowel, that it is commonly seen in boys, and only can go into the hernia sack. If that happens, it can twist in the hernia sack or cut of its blood supply, and a female can lose an ovary, if it's not dealt with immediately. So a lump in a girl in the groin area should be treated as an emergency and the physician contacted immediately.