Hydrocelectomy: Procedure, Recovery And Risks

Man sitting with a large and small egg between legs, imitating a hydrocele

What Is A Hydrocelectomy?

Hydrocelectomy is a surgical procedure used to treat or remove a hydrocele. A hydrocele is a condition that causes swelling of the scrotum due to the accumulation of fluid around one or both testicles. Hydoceles can develop at any age, but can occur quite frequently in baby boys.

A hydrocele will often go away on its own without the need for treatment. – but if a hydrocele becomes bigger, it could cause substantial swelling of the scrotum, along with possible pain and/or discomfort. If this is the case, surgical treatment may be required.

During a hydrocelectomy procedure, the fluid is removed and the sac that contained the fluid is significantly reduced in size as a result.

What Causes A Hydrocele?

Hydroceles occur in approximately 1% of adult men, most commonly after the age of 40. In these cases, hydroceles may be caused by complications involving the reproductive organs, including injury or trauma, infection, inflammation, or a blockage.

In newborn males, hydroceles are quite common. While the fetus is still developing, the testicles move from the abdomen down into the scrotum through a tract called the processus vaginalis. This tract normally closes after the testicles descend, but if it fails to do so it can become filled with fluid from the abdomen.

This condition normally goes away on its own after a few months. Nevertheless, it should be closely monitored by a pediatrician, pediatric urologist, or other specialist.

Who Needs A Hydrocelectomy?

You can develop a hydrocele and it may not cause you any discomfort or medical complications. In this case you can use over-the-counter medications that relieve pain and inflammation while waiting for the swelling to subside. The condition will frequently resolve itself within 6 months.

When a hydrocele becomes too large, however, it may need to be surgically repaired. Some signs that you may need to consider a hydrocelectomy include:

  • One side of the scrotum becomes significantly swollen
  • Pain occurring in one or both of the testicles
  • Discomfort due heaviness of the scrotum

Hydrocelectomy Procedure

For infants, the primary goal of the procedure is to close the processus vaginalis tract, which should have occurred naturally prior to birth. Adult men may need surgery if the size of the hydrocele becomes so noticeable that it causes embarrassment, if it is painful, or if it interferes with other genital-related functions.

Hydrocelectomy is usually performed on an outpatient basis. The procedure typically requires general anesthesia, meaning you’ll be unconscious during the surgery. To regulate your breathing, a tube will be placed in your throat. An intravenous line will be placed in your arm before the surgery to deliver fluids and any necessary medication.

In the standard procedure, a small incision is made in the scrotum, and suction is used to drain the hydrocele.

A hydrocelectomy can also be performed as a minimally invasive procedure using a small tube that has a light source and a camera on the end (laparoscope). The camera relays images from within the scrotum to a video monitor. Small instruments are then inserted through the small incision to carry out the repair.

Risks And Complications

It is normal to experience some bruising or swelling following a hydrocelectomy. However, with any surgical procedure there is a slight chance that the site of the operation may become infected, although this is rare.

You should not hesitate to call your doctor if you experience any pain, fever, or significant swelling. While some blood might seep onto the bandaging, your doctor should be immediately notified if you notice a heavy amount of bleeding.

If you observe symptoms of a possible infection, get in touch with your doctor as soon as possible. These symptoms include:

  • Redness or elevated temperature at the area of surgery
  • Pain and/or swelling that gradually worsens
  • Fluid with a foul odor seeping from the surgical site
  • Fever

Other potential difficulties that could occur include blood clots, fertility problems caused by damage to the testicle, or complications due to the anesthesia.

Non-Surgical Treatment

One alternative to a hydrocelectomy is a procedure known as aspiration. Aspiration involves inserting a needle directly into the hydrocele to remove the fluid.

Following the removal of fluid, the doctor injects a chemical into the sac surrounding the testicle, a technique called sclerotherapy. This procedure helps to keep fluid from forming again in the future.

A Study involving men in their fifties found that aspiration combined with sclerotherapy was effective at treating hydroceles 84% of the time. However, hydroceles may still return within a few months after using this procedure, which would require additional use of aspiration and sclerotherapy.

Surgery has the best long-term results, and a lower rate of hydrocele recurrence.(1)

Recovering From A Hydrocelectomy

The standard hydrocelectomy procedure usually takes around 30 minutes to perform. Normally, you can return home the day of the surgery. Your doctor may place a tube in your scrotum for fluid drainage, which is usually removed within one or two days.

You will be taken to a recovery area immediately after surgery for observation. If general anesthesia was used, you could feel grogginess or nausea, and you might have soreness in your throat from the breathing tube.

Patients are advised to apply ice or cold packs to the affected area for 24 hours after the procedure. They should also take pain relievers like ibuprofen. The doctor may prescribe stronger pain medication for patients who have had more extensive surgery.

Your doctor will schedule a follow up appointment within the next few weeks to ensure that everything is healing properly and that there is no indication of infection.

You can expect to have some soreness and swelling for the first few days after the operation, but there could be swelling for up to a month.

You will also have bandages on your scrotum. A jockstrap can be used to relieve discomfort by supporting your scrotum.

In order to keep swelling at a minimum, it may be necessary to apply cold packs for 10-15 minutes as needed for the first few days. Avoid getting the bandages wet until the wound heals. It is OK to shower as long as the bandages are covered to keep from getting wet.

Unless there was extensive surgery involved, most men can return to their normal activities within approximately two days.

Avoid lifting heavy weights or engaging in strenuous exercise while recovering from surgery. You may also be instructed to avoid having sex for up to six weeks. Do not drive when using prescription pain medication that causes drowsiness.

For infants, parents main goal should be to ensure that the surgical site is kept as clean and dry as possible.

There are rarely any major complications that develop from a hydrocelectomy, and the majority of these procedures are successful. Sometimes another hydrocele can appear after having surgery, which will also require treatment, but this is rare. and If you experience any swelling or pain returning to your scrotum, contact your doctor right away.

  1. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009735.pub2/full
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