Inguinal Hernias & Hydroceles

An inguinal (related to the groin) hernia occurs when a part of the intestine protrudes through a weakened spot in the abdominal muscles and into the groin area, while a hydrocele is a fluid-filled sac in the scrotum (the pouch that holds the testes.) Inguinal hernias are more common in boys than girls and tend to occur more often in premature babies.

 
What causes inguinal hernias and hydroceles?

Inguinal hernias and hydroceles are caused by a malformation of the inguinal canal. Before birth, the inguinal canal connects the abdominal cavity (belly) and a child’s normally descending sexual organs. This channel usually closes before or soon after birth, but if the connection remains open, fluid from the abdominal cavity can be trapped in the scrotum in boys and form a hydrocele.

If the connection is large enough, the intestine may be pushed into this space when a child strains causing a protrusion known as a hernia, which may look like a bulge or a lump in your child’s groin area.

 
How are inguinal hernias and hydroceles treated?

The majority of hydroceles go away by themselves by the time your child is 12 to 18 months old.

However, if your child’s hydrocele is very large, changes in size, or persists, or if the hernia can be seen or felt or causes discomfort in your child, your Nemours pediatric urologist may recommend surgical repair. When the hernia bulges out, it is usually soft and not painful to the touch.

If you notice that your child’s hernia is firm, red or tender, you need to call your doctor right away. With hernias, the intestine can become trapped in the hernial sac and cause serious problems, including injury to the intestines and the blood vessels that supply blood to the testes.

Most inguinal hernia and hydrocele repairs are done on an outpatient basis in the operating room and take about one hour. Your Nemours urologist will explain the surgical procedure to you and answer any questions you may have. Recovery time is generally short and your child may be able to take part in usual play activities in a day or so.

Bedwetting

Bedwetting is an issue that millions of families face every night. It is extremely common among young kids but can last into the teen years.

Doctors don't know for sure what causes bedwetting or why it stops. But it is often a natural part of development, and kids usually grow out of it. Most of the time bedwetting is not a sign of any deeper medical or emotional issues.

All the same, bedwetting can be very stressful for families. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.

Bedwetting may last for a while, but providing emotional support and reassurance can help your child feel better until it stops.

How Common Is Bedwetting?

Nocturnal enuresis, the medical name for bedwetting, is a common problem in kids, especially children under the 6 years old. About 13% of 6-year-olds wet the bed, while about 5% of 10-year-olds do.

Bedwetting often runs in families: many kids who wet the bed have a relative who did, too. If both parents wet the bed when they were young, it's very likely that their child will.

Coping With Bedwetting

Bedwetting usually goes away on its own. But until it does, it can be embarrassing and uncomfortable for your child. So it's important to provide support and positive reinforcement during this process.

Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about other family members who also struggled with it when they were young.

Remind your child to go to the bathroom one final time before bedtime. Try to have your child drink more fluids during the daytime hours and less at night. Avoid caffeine-containing drinks. Many parents find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

When your child wakes with wet sheets, don't yell or punish him or her. Have your child help you change the sheets. Explain that this isn't punishment, but it is a part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.

When to Call the Doctor

Bedwetting that begins abruptly or is accompanied by other symptoms can be a sign of another medical condition, so talk with your doctor.

The doctor may check for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes, or severe stress.

Call the doctor if your child:

  • suddenly starts wetting the bed after being consistently dry for at least 6 months
  • begins to wet his or her pants during the day
  • snores at night
  • complains of a burning sensation or pain when urinating
  • has to urinate frequently
  • is drinking or eating much more than usual
  • has swelling of the feet or ankles
  • your child is still wetting the bed at age 7 years

Also let the doctor know if your child is experiencing a lot of stress, if you're feeling frustrated with the situation, or could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about the bedwetting.

Remember, the long-term outlook is excellent and in almost all cases dry days are just ahead.

Reviewed by: Mary L. Gavin, MD
Date reviewed: January 2012