General Information
What is a hydrocele?
A hydrocele is a collection of fluid in the layers of tissue around the testicle.
The inciting cause is variable and is usually unknown.
In adults, it can occur as a response to infection or groin surgery.
Symptoms include swelling of one side of the scrotum with inability to palpate the testicle.
May or may not be painful/uncomfortable.
May make it harder to wear underwear or pants if large enough.
Diagnosis is confirmed with a scrotal ultrasound.
Treatment Options
Observation - hydroceles that are not too large and not uncomfortable for the patient may be safely observed
Aspiration - provides immediate relief from pain and/or size discomfort but will inevitably recur.
Surgery - hydrocelectomy is removal of the fluid and the sac that contains it
Description of the Procedure
This surgery is done in the operating room while you are under general anesthesia.
An incision is made in the scrotum over the swelling and the testicle with the hydrocele is delivered out of the incision.
The fluid is drained and the layers of tissue that held the fluid are trimmed and oversewn with stitches to help decrease the chance for recurrence.
The testicle is put back into place in the scrotum and the incision is closed with stitches and skin glue.
Risks and Complications
Risk to testicle and/or spermatic cord, including vas deferens and blood vessels.
15% recurrence despite surgical technique used.
Post-Operative Instructions
Wound Care
The incision is closed with skin glue that will flake off with time.
You may shower the day after surgery. Do not scrub the incision.
No baths or submersion in water for 2 weeks after surgery.
There may be some bleeding from the suture line. Apply gentle pressure until it stops.
The sutures will dissolve and fall out over the next 2-3 weeks.
Medications
Tylenol or ibuprofen are fine to take for pain.
Ice pack or cold pack will help with swelling.
You will not be prescribed narcotics/opioids after this procedure.
Activity
No heavy lifting or strenuous activity/exercise for 2 weeks after surgery.
You may resume sexual activity when you feel comfortable to.
A soon as you feel well enough, you may go back to work. This is typically about 48 hours after surgery (ie: if you have surgery on Monday, you can go back to work on Wednesday).
Post-Operative Follow-up
See your surgeon approximately 6 weeks after surgery to make sure things are healing up well and that all the sutures have fallen out.