Although testosterone levels fall as men age, the decline is steady at less than 2% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself. This has been somewhat misleadingly described as the ‘Andropause’ although in contrast to the menopause, there is no sudden cessation of hormones.

However, testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for symptoms of loss of sex drive, erectile dysfunction, low mood and other physical and emotional symptoms.


To diagnose the problem a specialist will need to carry out a physical examination where they will check for tenderness in the enlarged scrotum. They will also check the abdomen and scrotum to check whether there is an inguinal hernia while shining a light through the scrotum will enable them to check that there is clear fluid surrounding the testicle.

After a physical examination, a specialist might suggest blood and urine tests to rule out infection while an ultrasound will help to rule out a hernia, tumour or other causes of scrotal swelling.


One of the first symptoms of a hydrocele is a painless swelling on one or both testicles. In adult men, it can cause a level of discomfort as the swelling can create a feeling of heaviness. If the swelling increases then it is possible that it can become painful while the swelling could be less during the morning than in the evening.


Surgery may be required to remove the hydrocele Often, this is carried out as a daycase procedure and a hyrdocelectomy is carried out under either general or regional anaesthesia. The surgeon will make an incision in the scrotum and then remove the hydrocele.

After surgery, in most cases, the patient can return home the same day. However, in some instances, a tube might be required to drain the fluid while a dressing will need to be worn for a few days. Your specialist is then likely to request a follow-up examination to ensure that everything has healed but to also make sure that it has not recurred.