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The hydrocele is opened completely (D), and skin and tissue layers are stitched (E).( A hydrocele usually appears as a soft swelling in the membrane surrounding the testes.This failure to close allows peritoneal (abdominal) fluid to flow into the scrotum.

In addition to filling the tunic vaginalis, the fluid may also fill a portion of the spermatic duct (epididymis) in the scrotum.

In adults, hydroceles develop slowly, usually as a result either of a defect in the tunica vaginalis that causes overproduction of fluid, or as a result of blocked lymphatic flow that may be related to an obstruction in the spermatic cord.

Hydroceles may also develop as a result of inflammation or infection of the epididymis; trauma to the scrotal area; or in association with cancerous tumors in the groin area.

Inflammation is not usually present, although if the hydrocele occurs in conjunction with epididymitis (inflammation of the epididymis), the testes may be inflamed and painful.

The main symptom of a hydrocele that occurs without epididymitis is scrotal swelling.

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