In normal testicular development the testicle descends and travels through the abdomen into the scrotum during the last few months of pregnancy. Typically the ‘tunnel’ from the abdomen to the scrotum (called the processus vaginalis) closes at birth or during the first year of life. However, it is not uncommon for the tunnel to remain open allowing fluid or bowel to enter, which is called a hydrocele or hernia.
Inguinal hernias occur in up to 4% of children and 30% of premature infants. Hernias are nine times more common in boys and are most commonly (60%) found on the right side.
When there is just fluid in the scrotum it is called a hydrocele and this typically resolves within the first year. If a hydrocele gets larger (rather than smaller), causes pain or discomfort and persists beyond the first year of life, surgical intervention is necessary. If bowel gets down into the inguinal canal or scrotum, it is called a hernia. If this causes discomfort, becomes red and hard, or makes the child ill (that is, vomiting, nausea, fever), surgical intervention is necessary.