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.