What is a hydrocelectomy?

Hydrocelectomy is surgery that is done to remove or repair a hydrocele. A hydrocele is a fluid-filled sac surrounding a testicle that causes swelling in the scrotum (the pouch that holds the testicles). Hydroceles can be scary because you can see them and because they are in a sensitive part of the body. They are usually painless and often improve without treatment. However, you should discuss any abnormality in the scrotum with a doctor right away as it could be a more serious problem.

What causes hydroceles?

Hydroceles are common in newborn males. During fetal development, the testicles descend from the abdomen to the scrotum down a tract known as the processus vaginalis. When this tract fails to close after the testicles descend, the scrotum can fill with fluid from the abdomen. This situation usually resolves within a few months. However, it needs to be watched closely by a pediatrician, a pediatric urologist, or a similar doctor.

In adult men, hydroceles can result from inflammation in the reproductive system, from injury, from an infection, or from a blockage in the spermatic cord or scrotum. About 1% of adult men will get a hydrocele.

How are hydroceles diagnosed?

Hydroceles are diagnosed by having a doctor examine the scrotum. The first thing the doctor will do is make sure the patient does not have testicular torsion. Testicular torsion is when one testicle rotates in a way that it loses its blood supply. This is a serious and painful condition that requires emergency surgery to prevent having to have the testicle removed. This problem happens most commonly in a boy’s early teen years.

With a hydrocele, the scrotum is enlarged but it is not tender or painful. Because the fluid causing the swelling is clear, a flashlight shined through the scrotum will show the outline of the testes. This use of light suggests the problem is a hydrocele but is not the only test a doctor will perform. Ultrasound also is used to confirm a diagnosis and to rule out other possible problems.

Other tests such as blood and urine tests also can be used to learn if the patient has inflammation or an infection.

Can hydroceles be prevented?

Hydroceles in infants cannot be prevented.

Since hydroceles in adult men tend to be the result of trauma to the testicles, men should try to prevent any injuries to this part of the body. This would include wearing a protective athletic cup during sports or other activities in which the testicles could be injured.

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