What will happen if I don't have my communicating hydrocele repaired?

May Lead to a hernia. A communicating hydrocele allows free flow of abdominal fluid back and forth to the scrotal sac. It could also (depending on the size of the communication) allow intestines to travel throught the hydrocele channel to the scrotum. That would become a hernia. If the contents get stuck in the scrotum, that would be called an incarcerated hernia and is a medical emergency.
Enlarge. Communicating hydroceles can continue to enlarge and become more uncomfortable. There's a small risk of associated hernia that can also get worse without repair.