Hydrocele repair

Small hydroceles which are not causing symptoms do not require treatment, however there are some situations in which surgical repair may be considered:

• The hydrocele has been present for some months and is growing
• There is swelling on one side of the scrotum
• There is pain in one or both testicles
• There is heaviness and discomfort due to the enlargement of the scrotum

Surgical hydrocele repair is a long-term solution for symptomatic patients.

Aspiration (inserting a needle into the scrotum and withdrawing the fluid) is an alternative treatment that may be considered. Following aspiration, a substance may be injected into the scrotum to prevent the hydrocele building up again. Whilst this may be effective initially, in a significant number of patients, the problem returns within a few months and may be complicated by infection.

• The patient is placed under general anaesthetic for the duration of the procedure, which usually takes around half an hour to complete
• An incision is made in the scrotum
• The fluid is drained from the hydrocele
• The hydrocele ‘sac’ (excess tissue) is removed to prevent recurrence
• The incision is closed using dissolving stitches

• Hydrocele repair is usually conducted as a day procedure, so in most cases you can go home following your surgery
• The size of the scrotum will be visibly reduced
• Some mild pain or discomfort, as well as swelling and bruising may be present for up to 2 weeks
• In some cases, slight thickening of the scrotum occurs, but this generally reduces over a period of months following the surgery
• You will need relative rest for a week or so after surgery and avoid any strenuous activity for about 4 weeks to prevent bleeding

Hydrocele repair surgery is an effective long-term solution for correcting fluid build-up around the testicle. Recurrence of hydrocele is possible but uncommon following this procedure. The risk of this is higher in patients with a very large hydrocele.

What to expect:

• Bruising may be noticeable on the skin; you may take paracetamol or ibuprofen for discomfort
• There may be some bleeding at the wound site; you may wear a light pad in the underwear if necessary
• Swelling may persist for a number of weeks following the procedure

Return to activity:

• Driving – no driving for one week and until you are pain free
• Work – you will require some time off work; the duration will depend on your occupation. Generally, you may return to light duties after a week
• Lifting – avoid heavy lifting for at least 2 weeks following your procedure to avoid bleeding
• Activities – walking is fine and encouraged following your procedure, however you should avoid strenuous activity for a week following your procedure
• Sex – avoid for 2 weeks
• You may shower after 24 hours but avoid soaking in the bath for at least one week
• Keep your wound dry and clean

Pain Management:

Scrotal discomfort will usually resolve in 1-2 weeks following the procedure. We suggest that you wear supportive underwear to help minimize swelling. You may take ibuprofen or paracetamol if you are experiencing discomfort.

FAQ:

Do my sutures need to be removed?

The suture material that is used to close the wound is dissolvable, but this will take a number of weeks

Head to your nearest hospital emergency room if:

• You have progressive bruising or swelling (this is uncommon, but may indicate bleeding)
• Fevers, chills or shakes (may indicate infection)
• You have pain that cannot be controlled with medication

Follow-Up Information:

Our rooms will arrange a follow-up appointment with your urologist typically 6-8 weeks after the procedure.

Your follow-up appointment is on: ____________________ at __________________.

Contact Information:

If you have any questions or concerns that are not addressed here or in the procedure information available on our website melbourneurologycentre.com.au contact our rooms on 1300 702 811 or [email protected]

Post-Operative information for this procedure can be found here: Hydrocele Post-Operative Care Instructions

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

Rioja, J., sanchez-Margallo, F. M., Uson, J., Rioja, L. A., (2011), Surgery Illustrated- Surgical Atlas: Adult hydrocele and spermatocele, BJU International, 107, [https://www.profnatali.it/uploadedfiles/o_1aupaeb471ku9qj1ov21ggpi4ne.pdf], accessed 19/02/21.