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.
What happens during a hydrocelectomy?
If there is pain in the scrotum, pain relievers can be used to treat this symptom of hydroceles. Some cases will clear up on their own with time. However, sometimes surgery is needed.
In infants, the surgery focuses on closing the processus vaginalis, which should have closed on its own before birth. In adult men, surgery may be done when the swelling from the hydrocele is painful, embarrassing, or when it grows to a size that threatens the function of the rest of the genital tissues.
Surgery is usually performed under general anesthesia (the patient is given drugs to put him to sleep). After the patient is asleep surgery includes these steps:
- The surgeon makes a small cut in the scrotum or groin close to the scrotum and drains out the fluid via suction.
- The surgeon also closes the communication to the canal between the abdominal cavity and the scrotum.
- The hydrocele sac is then removed and the incision is closed up.
- If the patient also has a hernia, the surgeon will probably repair that as well.
Risks / Benefits
What are the symptoms of a hydrocele?
Men (and parents of infants) will tend to notice swelling in one or both testicles when there is a hydrocele. The scrotum with the hydrocele has been described as feeling like a water-filled balloon. It is not usually painful.
Recovery and Outlook
What happens after hydrocelectomy?
This surgery is a relatively minor one and most patients return home the same day. It is recommended that patients apply ice packs to the area for 24 hours following the procedure and they should take pain relievers such as ibuprofen. For patients who need more extensive surgery, the surgeon may prescribe a stronger pain reliever.
Some patients will have a small amount of bruising and swelling but that is normal. As with any surgery, there is a small chance of the surgical area becoming infected. If there is fever, pain, or heat or a lot of swelling in the treated area, you should call the doctor right away. A small amount of blood may seep out onto the bandages but a heavy amount of blood should be reported to the doctor right away also.
Some patients will go home with a small drain coming out of the surgical site to help remove any fluids from the tissue. The doctor usually will remove it in a day or two.
Will I have any limitations after hydrocelectomy?
Most patients can resume normal activities in about 2 days, unless their surgery was extensive. For infants, parents should take care to keep the area as clean and dry as possible. Adult men generally should wait at least 2 weeks to resume strenuous work or sexual activity. Showering is generally OK but bathing should be avoided until the area has healed.