Silvia Azaña, an embryologist at inviTRA, explains the different types of hydrocele in this video:
The testicles are located inside a pouch called the scrotum. In the scrotum, the testicles are naturally immersed in a small amount of fluid that helps them remain mobile and also makes them less vulnerable to external impacts. Therefore, we use the term testicular or scrotal hydrocele when the amount of fluid in this area is greater than what is considered normal. Testicular hydrocele is the most common type of hydrocele, and approximately 5% of male newborns present with this condition. There are two main causes of hydrocele that lead to the two basic types of this condition: congenital hydrocele and acquired hydrocele. We are going to discuss each of them.
Congenital hydroil is a type of swelling in newborn babies. It is the most common type of testicular hydrocele and it's also called a communicating hydrocele. This type of hydrocel occurs in cases when the tunica vaginalis of the testicle has not completely closed, thereby maintaining an open communication with the peritineal cavity. This condition causes fluid to flow into the scrotal cavity, meaning that there is a passage of fluid into the scrotum. During normal development, the testicles descend slowly through a duct that runs from the abdomen to the scrotum. In this case, hydrocele occur when this duct fails to close properly. This allows fluid to pass through this duct, which remains open, from the abdomen and accumulate in the scrotum. For this reason, the testicle appears swollen. Additionally, congenital hydrocele may or may not be accompanied by an inguinal hernia. This congenital hydrocele is very common in babies, but usually disappears between 18 and 24 months of age. If not, the communicating hydrocele requires surgery.
In contrast to the previous type, the hydrocele can also be acquired or non-communicating. The main reason for the accumulation of fluid in non-communicating hydroceles is inflammation, which can develop due to a variety of different causes or underlying factors such as infections, testicular torsion, trauma, epidomitis, tumor, etc. On the other hand, surgery performed in the testicular area, including procedures such as a vasectomy, a varicocele intervention, or an inguinal hernia, could also be possible causes for the appearance of a hydrocele. Acquired hydrocele occurs in children and adults, but it is most common for non-communicating hydrocele to occur in men over 40 years old.
