What are the potential complications of untreated hydrocele that I should discuss with my patients?

Untreated hydrocele can potentially lead to complications such as persistence beyond infancy in congenital cases, which may require surgical intervention if it does not resolve by 12 months of age or if associated with other conditions like inguinal hernia or testicular pathology. In adults, a large or symptomatic hydrocele may cause discomfort and require referral for possible surgical repair. There is also a risk that an untreated hydrocele could mask or delay diagnosis of underlying serious conditions such as testicular cancer, epididymo-orchitis, or trauma, especially if the testis cannot be palpated. Rarely, complications like infection or severe pain may develop, necessitating delayed surgery. Therefore, monitoring and appropriate referral are important to prevent these complications ¹.