Hydrocele repair

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Who is suitable for a hydrocele repair?

What are the advantages of having a hydrocele repair?

How is a hydrocele repair performed?

What to expect after a hydrocele repair?

Procedure outcomes

INTRODUCTION

A hydrocele repair is a procedure to correct a hydrocele, which is a build-up of fluid in the scrotum, around the testicle. Hydroceles are very common in newborns and young children, but can also occur in men, typically after 40 years of age. As a hydrocele grows larger, it can cause pain and swelling in the scrotum. Whilst a hydrocele does not usually damage the testicle, it may be very uncomfortable, requiring treatment.

In adults, a hydrocele may develop:

  • As a result of blocked lymphatic flow related to an obstruction in the spermatic cord
  • As a result or inflammation or infection of the epididymis or testicle
  • Due to trauma in the scrotal area
  • Following surgery such as an inguinal hernia
  • In association with some tumours in the area
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Who is suitable for a 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

What are the advantages of having a hydrocele repair?

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.

How is a hydrocele repair performed?

  • 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

What to expect after a hydrocele repair?

  • 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

Procedure outcomes

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.

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