Pediatrics
Inguinal Hernia and Hydroceles
Our experienced pediatric urologists and urologic surgeons offer compassionate care for children with inguinal hernias and hydroceles.
Medically reviewed by Yvonne Chan, M.D. on April 19, 2026.
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What Are Inguinal Hernias and Hydroceles?
Inguinal hernias and hydroceles are closely related conditions in babies and children. They happen before a baby is born when their inguinal canal doesn’t close as it should. Your baby has an inguinal canal on each side of their body. The canals run from the wall of the lower belly to the genitals.
Inguinal hernias are also known as indirect inguinal hernias. They happen when part of your baby’s small intestine or other tissue pushes through an opening in their inguinal canal, causing a bulge. Boys and girls can have inguinal hernias.
Hydroceles only affect boys. There are two types:
- Communicating hydroceles happen when fluid moves through an opening in the inguinal canal into the pouch that holds the testicles (scrotum). The fluid collects in a thin sac that surrounds a testicle, causing the scrotum to swell.
- Noncommunicating hydroceles happen when over production of fluid from the scrotal lining causes the scrotum to swell. This is common in babies but can also happen from trauma or infection.
Your baby needs surgery to treat an inguinal hernia to reduce risk of the intestine being trapped in the hernia. Hydroceles that don’t go away within a baby’s first 18 months may also require treatment.
Symptoms of Inguinal Hernias and Hydroceles
Hydroceles don’t cause pain or other symptoms. An inguinal hernia with intestine or abdominal contents caught in it may be painful. Signs of a hernia may be noticeable at birth or become more apparent when your baby is a few weeks old.
Common Symptoms
Signs of an inguinal hernia include:
- Bulge in the groin area (between a baby’s lower belly and thigh)
- Bulge or swelling in the labia (outer lips of a girl’s vulva)
- Bulge or swelling in the scrotum
- Bulge that gets bigger when your baby cries or strains, and smaller when they’re sleeping
- Fussiness or irritability
Emergency Symptoms
In rare instances, part of the intestine can get trapped in the hernia sac (incarcerated hernia). Without prompt medical care, blood can stop flowing to the intestine, causing life-threatening tissue damage (strangulated hernia). These conditions are medical emergencies. Symptoms include:
- Bloody stool
- Fever
- Nausea and vomiting
- Redness and firm swelling at the hernia site
- Severe belly or groin pain
- Swollen belly
Inguinal Hernias and Hydroceles Causes and Risk Factors
Inguinal hernias and hydroceles are congenital abnormalities (birth defects) that are present at birth. Something happens while a baby is in the womb that stops the inguinal canal from closing as it should. Medical experts aren’t sure why this happens.
Some risk factors for inguinal hernias and hydroceles include:
Biological Sex
Inguinal hernias are more common in boys. Hydroceles only affect boys.
Family History
A baby is more likely to have an inguinal hernia if a sibling or close family member had one.
Low Birth Weight
Babies who weigh less than 5 pounds 4 ounces at birth are more at risk for hernias and hydroceles.
Preterm Birth
The conditions are more common in preterm babies born before the 37th week of pregnancy. These babies also tend to have low birth weights.
Diagnosis and Testing for Inguinal Hernias and Hydroceles
Health care providers typically diagnose hydroceles and inguinal hernias during a physical exam. In rare cases, your baby may get additional tests.
Imaging Test
An ultrasound can help your baby’s provider diagnose a hydrocele, hernia or mass.
Treatments for Inguinal Hernias and Hydroceles
Children with inguinal hernias need surgery to close the canal opening. If your child has a hydrocele that doesn’t go away by their first birthday, we will treat both conditions in one surgery. Your child receives general anesthesia and sleeps through this outpatient procedure.
Inguinal Hernia Repair
A surgeon makes a small cut in the groin area. After putting the intestine or contents of the hernia sac back into place, they use stitches to close the hernia opening.
Hydrocele Surgery (Hydrocelectomy)
A surgeon drains fluid from the hydrocele sac and removes the sac.
Of newborn boys, about
1 in 10Have hydroceles
About
1 in 100Babies have inguinal hernias
Source: Urology Care Foundation: What are hydroceles and inguinal hernias?
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