Hydrocelectomy

What is a hydrocelectomy?

A hydrocelectomy (HI-dra-see-leck-TOH-mee) is a surgery that removes or repairs a hydrocele (HI-dra-seel). A hydrocele is a fluid-filled sac that surrounds your testicle (teste). It causes swelling in your scrotum.

It’s normal to feel worried, anxious or even afraid about any type of surgery, especially one that involves a sensitive body part. Healthcare providers understand your feelings. If a hydrocele causes problems and requires a hydrocelectomy, they’ll explain the procedure to you, including the expected outcome and recovery process.

What is a bilateral hydrocelectomy?

You may need a bilateral hydrocelectomy if you have hydroceles around both of your testicles. “Bilateral” means that hydroceles affect your left and right testicles. Fortunately, healthcare providers can usually treat both sides through one cut (incision).

What does a hydrocelectomy treat?

A hydrocelectomy treats a hydrocele. Hydroceles commonly affect infants. But they can occur at any age.

In infants, a hydrocele occurs due to the incomplete closure of a membrane between the scrotum and the lining of the abdominal cavity (processus vaginalis). So, a hydrocelectomy in an infant focuses on closing this thin membrane.

In older children, teens or adults, a hydrocele can form from many different causes. Typically, a healthcare provider can monitor a hydrocele without treating it (intervention). A hydrocelectomy is only necessary if the hydrocele swelling is painful, causes difficulty walking or is embarrassing.

What is the main cause of a hydrocele?

Hydroceles typically occur during fetal development. During typical fetal development, a thin membrane (processus vaginalis) forms between the stomach lining and scrotum. The testicles eventually move from the abdomen through this membrane into the scrotum. Once this is complete, tissue blocks off the opening. But if the tissue doesn’t form or closes a little later, abdominal fluid can flow into the scrotum and cause a hydrocele.

In adults, hydroceles can develop due to many different causes, including:

• Infection.
• Injury.
• Inflammation.

How common are hydrocelectomies?

A hydrocelectomy is a relatively common procedure.

About 10% of all babies assigned male at birth (AMAB) have a hydrocele at birth. Hydroceles often go away on their own. But sometimes, a hydrocele develops in older children or adults after an injury or infection. If a hydrocele appears after 12 months of age, a hydrocelectomy is usually necessary.

About 1% of adults AMAB will get a hydrocele.

While healthcare providers can typically monitor a hydrocele, it’s important for a provider to evaluate you if you experience a new onset of swelling in your scrotum. Other causes of swelling may require treatment.

How should I prepare for a hydrocelectomy?

Before a hydrocelectomy, you’ll meet a healthcare provider. They’ll explain the procedure and ask for your consent. They’ll evaluate your general health by conducting a physical exam. They’ll also ask questions about:

• Your health history, including any previous injuries, infections or surgeries in the area.
• Any prescription or over-the-counter (OTC) medications you’re taking, including herbal supplements. Certain medications, such as blood thinners, can increase your risk of bleeding.
• Any allergies you have.

In adults or teenagers who’ve gone through puberty, a provider may ask you to shave away the pubic hair from your entire scrotum or groin area the night before or the morning of your procedure. Don’t use an electric razor on your scrotum. A single-blade disposable razor is the best choice.

To reduce your risk of infection, thoroughly wash your scrotum and groin with soap and clean water the day before and the morning of your hydrocelectomy.

Who makes up my hydrocelectomy team?

A hydrocelectomy team generally consists of:

• An anesthesiologist.
• A urologist.
• Nurses.

What happens during a hydrocelectomy?

An anesthesiologist will first place you under general anesthesia to make you comfortable. You’ll be asleep during the entire procedure and won’t feel any pain.

Once you’re asleep, the urologist will:

• Make a small cut (incision) in your scrotum or groin near your scrotum. If you have a hydrocele that has contact with the fluids in your abdominal cavity (communicating hydrocele), they’ll close the opening between your processus vaginalis and scrotum.
• Remove the hydrocele sac. Sometimes, they’ll turn the tissue inside out to reduce the risk of a hydrocele coming back (recurrence).
• Repair a hernia, if necessary. Hernias sometimes develop alongside hydroceles.
• Stitch a small, silicone tube (surgical drain) in your affected area to drain blood or fluids.
• Close the incision with stitches.

How long does a hydrocelectomy take?

In most cases, a hydrocelectomy takes less than an hour.

What happens after a hydrocelectomy?

After the hydrocelectomy is complete, a healthcare provider will cover your stitches with bandages and the anesthesiologist will stop giving you anesthesia.

You’ll move to a recovery room, where providers will wait for you to wake up, manage your pain and monitor your overall health. In most cases, a hydrocelectomy is an outpatient procedure. That means you can go home the same day as the surgery. Once the providers determine that you no longer require monitoring, they’ll let you go home (discharge you).

Is hydrocele surgery worth it?

There are many advantages to a hydrocelectomy, including:

• Preventing inguinal hernias in babies. An inguinal hernia in a baby is a hernia that occurs in their groin. It happens when part of their small intestine pushes through an opening in their abdominal wall through their inguinal canal. A hydrocelectomy helps prevent an inguinal hernia from developing.
• Improved comfort. Hydroceles may make it difficult to sit, lie down, walk or run comfortably.
• Self-esteem boost. Most people like their hydrocele surgery results.
• Safety. A hydrocelectomy is a relatively safe procedure. It has a low risk of complications or side effects. Most people return home the same day.

How successful is a hydrocelectomy?

Hydrocelectomies have a high success rate, and the long-term outlook is very good.

What are the risks or complications of a hydrocelectomy?

All surgical procedures carry some risk. Some hydrocelectomy risks include:

• Anesthesia risks.
• Healing problems.
• Infection.
• Mass of clotted blood (hematoma).
• Swelling.
• Bruising.
• Unfavorable scarring.
• Injury to the testicle or surrounding structures, which can impact your ability to have biological children (fertility) or testosterone production.

It’s also possible that a hydrocele comes back, even after a successful hydrocelectomy.

What happens if a hydrocele is left untreated?

Sometimes, hydroceles in infants go away without treatment. But if you have an enlarged scrotum that doesn’t go away on its own and you don’t get treatment, you have an increased risk of:

• Discomfort.
• Pain.

On rare occasions, a hydrocele may indicate a more serious underlying condition, such as testicular cancer.

What is the recovery time for a hydrocelectomy?

Most people can resume activities about two days after a hydrocelectomy. If a healthcare provider placed a surgical drain, they’ll remove it a day or two after surgery.

If you have a large hydrocele, the skin in your scrotum may stretch out, and you may have loose skin after a hydrocelectomy. Your scrotum may shrink back (recoil) to its typical size a few weeks to a month after the procedure.

You should avoid activities that involve heavy lifting for the first two to four weeks after surgery to reduce the risk of worsening swelling, which can prolong the healing process. You should also avoid strenuous activities, such as running and swimming, and sexual activity, including masturbation, for at least two weeks after a hydrocelectomy. Children should avoid straddle toys as they recover, such as a bicycle, see-saw, rocking horse and swing. Showering is typically OK. But you should avoid bathing until the area heals.

For infants, you should keep the area as clean and dry as possible to help prevent infection.

It’s important to remember that your body is unique, so your recovery time may be different from others. Follow your healthcare provider’s instructions on how to manage pain and discomfort.

How can I take care of myself at home after a hydrocelectomy?

You should apply ice packs to the area for at least 24 hours after a hydrocelectomy. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) help provide relief for mild pain. The most common NSAIDs include aspirin (Bayer®), ibuprofen (Advil®) and naproxen (Aleve®). Not everyone can take NSAIDs. Be sure to check with a healthcare provider before use. You should also use acetaminophen (Tylenol®) to treat mild pain.

If you need more extensive surgery, the surgeon may prescribe a stronger pain reliever (analgesic).

A healthcare provider may also recommend you wear a tight pair of supportive underwear (briefs) or a jockstrap after a hydrocelectomy. Briefs or a jockstrap help support your scrotum and reduce swelling.

How long should I wear a jockstrap after hydrocele surgery?

It’s typically a good idea to wear a jockstrap or briefs for up to a week after hydrocele surgery. Wear it all day, even while you’re sleeping.

When can I go back to work/school?

Your scrotum and incision need time to heal. It’s a good idea to take between five and seven days off work or school. If you have a physically demanding job, you may need up to two weeks to recover before returning to work.

When should I call a healthcare provider?

Schedule a follow-up appointment with a healthcare provider after your hydrocelectomy. They’ll want to check your incision and take your stitches out after a week. If you have a surgical drain, they’ll remove that, as well.

Contact a provider immediately if you experience any abnormal symptoms after the procedure. Symptoms may include:

• Heavy bleeding.
• A fever of 100 degrees Fahrenheit (38 degrees Celsius) or higher.
• Discoloration in the affected area (red, purple, brown or black).
• Significantly worsening pain or swelling.

How painful is hydrocele surgery?

A hydrocelectomy is mildly painful. You may have some discomfort or pain in the area for up to a week after the procedure. Most people find that ice and NSAIDs help reduce pain.

Is hydrocelectomy a major surgery?

A hydrocelectomy is a relatively minor surgery. Most people return home the same day.