Hydrocelectomy

A hydrocelectomy is a surgery that removes or repairs a hydrocele, which is a fluid-filled sac surrounding your testicle. The procedure usually takes less than an hour to complete. Risks include healing issues, infection, swelling, bruising and scarring. It may take two or more weeks to recover.

Overview

What is a hydrocelectomy?

A hydrocelectomy (pronounced “hi-dra-see-leck-toh-mee”) is a surgery that removes or repairs a hydrocele (pronounced “hi-dra-seel”). A hydrocele is a fluid-filled sac surrounding your testicle. It causes swelling in your scrotum, which is the pouch that holds your testes (testicles). You may need a bilateral hydrocelectomy if you have hydroceles around both of your testicles. “Bilateral” means that the condition affects your left testicle and right testicle.

Hydroceles can be scary because you can see them and they’re in a sensitive part of your body. They’re usually painless and sometimes improve without treatment. However, you should discuss any abnormality in your scrotum with your healthcare provider right away. It could be a sign of a more serious problem.

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Who needs to have a hydrocelectomy?

Men and people assigned male at birth (AMAB) may need a hydrocelectomy if they have an enlarged scrotum that doesn’t go away on its own. Healthcare providers may recommend a hydrocelectomy for anyone with a hydrocele, regardless of age.

Why is a hydrocelectomy done?

In infants, a hydrocelectomy focuses on closing the processus vaginalis. The processus vaginalis typically closes on its own before birth.

In teens or adults, surgery may be necessary when the swelling from the hydrocele is painful, embarrassing or grows to a size that threatens the functions of your other genital tissues.

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How common are hydrocelectomies?

A hydrocelectomy is a relatively common procedure.

About 10% of all baby boys, babies assigned male at birth, are born with a hydrocele. The hydroceles often go away on their own. If a hydrocele appears after 12 months of age, a hydrocelectomy is usually necessary.

About 1% of adult men and people AMAB will get a hydrocele.

Procedure Details

What happens before a hydrocelectomy?

Before a hydrocelectomy, you’ll meet with your healthcare provider. They’ll evaluate your or your child’s general health. They’ll also take vitals (temperature, pulse and blood pressure).

Tell them about any previous injuries, infections or surgeries you’ve had on your genitals or groin.

Also, tell them about any prescription or over-the-counter (OTC) medications you, or your child, are taking, including herbal supplements. Aspirin, anti-inflammatory drugs and certain herbal supplements can increase your risk of bleeding.

In adults or teenagers who have gone through puberty, your healthcare provider may ask you to shave away the 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 the risk of infection, thoroughly wash your scrotum and groin the day before and the morning of your hydrocelectomy.

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What happens during a hydrocelectomy?

Your healthcare provider will place you under general anesthesia to keep you comfortable.

Once you’re asleep, your healthcare provider will make a small incision (cut) in your scrotum or groin near your scrotum.

If you have a communicating hydrocele, your healthcare provider will close the opening (communication) between your processus vaginalis and your scrotum.

Your healthcare provider will then remove the hydrocele sac.

In some cases, your child may have a hernia and a hydrocele. If your child has a hernia or your surgeon discovers a hernia during the procedure, they’ll repair that as well.

Your surgeon may place small silicone tubes in your affected area to drain blood or fluid. They’ll stitch the tubes into place.

Finally, they’ll stitch the incision closed.

How long does a hydrocelectomy take?

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

What happens after a hydrocelectomy?

After the procedure is complete, your healthcare provider will cover your stitches with bandages.

The anesthesiologist will stop putting anesthesia into your child’s body to keep them asleep.

Your child will move to a recovery room, where healthcare providers will wait for them to wake up and monitor their overall health. Most hydrocelectomies are outpatient procedures, so your child can go home the same day as surgery.

Once your healthcare providers determine that you no longer need monitoring, they’ll let you go home (discharge you).

You should apply ice packs to the area for at least 24 hours after a hydrocelectomy.

OTC 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, so it’s a good idea to check with your healthcare provider before use. If you need more extensive surgery, your surgeon may prescribe a stronger pain reliever.

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Risks / Benefits

What are the advantages of a hydrocelectomy?

There are many advantages to a hydrocelectomy, including:

  • Preventing inguinal hernias in babies. An inguinal hernia in an infant is a hernia that occurs in their groin. It happens when part of their 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 the results of their hydrocelectomy. They’re happy with how their scrotum looks after the procedure.
  • Safety. A hydrocelectomy is a relatively safe procedure with a low risk of complications or side effects. Most people return home the same day.

What are the risks or complications of a hydrocelectomy?

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

  • Anesthesia risks.
  • Healing problems.
  • Infection.
  • Mass of clotted blood (hematoma).
  • Swelling.
  • Bruising.
  • Unfavorable scarring.
  • Recurrence.

Recovery and Outlook

What is the recovery time after a hydrocelectomy?

Most people can resume normal activities about two days after a hydrocelectomy. Your healthcare provider will remove the drain a day or two after surgery (if one was placed).

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

You should avoid strenuous activities and sexual activity for at least two weeks. Showering is OK, but you should avoid bathing until the area has healed.

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

It’s important to remember that your or your child’s body is unique, so recovery times may vary. Follow your healthcare provider’s instructions on how to manage pain and discomfort.

When can I go back to work or school?

Your affected areas 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 to Call the Doctor

When should I see my healthcare provider?

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

Contact your healthcare provider immediately if you or your child experience any abnormal symptoms after a hydrocelectomy. Symptoms may include heavy bleeding, a fever of 100 degrees Fahrenheit (38 degrees Celsius) or higher, infection or increased pain or swelling in your affected area.

Additional Details

How painful is a hydrocelectomy?

You may have light pain and discomfort after a hydrocelectomy. You can manage your pain with NSAIDs or a prescription pain reliever.

Is a hydrocelectomy a major surgery?

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

A note from Cleveland Clinic

A hydrocelectomy is a procedure that removes or repairs a hydrocele, a fluid-filled sac surrounding your testicle. It causes swelling in your scrotum, which is the pouch that holds your testes (testicles). A hydrocelectomy can improve your or your child’s quality of life and may prevent other conditions from developing. You may feel a little nervous, but a hydrocelectomy is a relatively safe procedure. Talk to your healthcare provider about your questions and concerns, and learn more about the outcomes and risks.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 06/06/2022.

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