If your child have a scrotal swelling he is likely to have hernia or hydrocele (mostly painless) or testicular torsion (Very painful and its emergency).

What is an inguinal hernia or hydrocoele?

A hernia is a lump in the groin and a hydrocoele is a scrotal swelling.

As your baby boy is developing during pregnancy, the testes develop in the abdomen (tummy) and then move down through a tunnel called the inguinal canal into the scrotum.

Usually, this tunnel closes shortly after your baby is born. If it does not close, a loop of intestine can move in and out of it, causing a hernia. If the opening is small it may only allow fluid through, rather than the intestine itself, and this causes what is known as a hydrocoele.

Girls have the same tunnel, so they can develop hernias in this area also, although this is less common. Hydrocoeles in girls are also very rare.

How are they diagnosed?

The doctors will feel your child's abdomen and scrotum to see if the swelling is caused by fluid or something solid.

To confirm that the swelling is a hydrocele and filled with clear fluid, the doctor may shine a torch through the scrotum. The outline of the testicles will show up and the rest of the scrotum will show the light.

If it is a solid lump that can be pushed back into the tummy, the doctor will confirm that it is an inguinal hernia.

Usually, the doctor will confirm that both testicles are present in the scrotum during the same examination.

How are they treated?

Most hydroceles go down within a few months of birth, but occasionally they last longer. If a hydrocele is still present after two to three years or is causing any problems, an operation might be suggested.

If your child has an inguinal hernia, this will need to be corrected in an operation. If the bowel remains trapped in the scrotum, it could become damaged due to pressure on the blood supply to the area. This is called strangulation and could lead to that portion of the lining and bowel dying off, which can result in serious infection and bowel problems.

The testicle can also be damaged by poor blood flow to the area. For this reason, we will try to arrange the operation earliest possible.

What does the operation involve?

The operation is carried out under general anaesthetic, using open surgery., the operation lasts for about an hour. Once your child is asleep, the surgeon will make a small incision (cut) on the lower abdomen to find the passageway and separate the blood vessel and testicular cord.

If your child has an inguinal hernia, any abdominal lining and/or bowel will be moved back to the abdomen. If your child has a hydrocele, the fluid will be drained away from the scrotum. The passageway will be closed with a stitch and the incisions on the skin will be closed with dissolvable stitches and skin glue. During keyhole surgery, the surgeon will check the other side of the scrotum for a similar passageway and close this with a stitch if needed.

What happens after the operation?

Your child will recover from the anaesthetic on the ward. Very young babies usually stay overnight after the operation so that we can monitor them closely while recovering from the anaesthetic. Once your child feels comfortable and has had a drink, you will be able to take him home. We recommend that you bring in some loose clothing for your child to wear home and for the next few days, as this will be a lot more comfortable.