What is Hydrocelectomy?

Who Needs Hydrocele Surgery?

Surgery is recommended when the hydrocele is large enough to cause discomfort, when it has persisted for more than 12 months in infants, when it is associated with a hernia, when conservative management has failed, or when the condition is causing significant impact on daily life. Adults with symptomatic hydrocele and infants with persistent communicating hydrocele are the most common candidates.

Diagnosis

Diagnosis of hydrocele requiring surgery includes:

• Physical examination of the scrotal area to assess swelling and size
• Transillumination test to differentiate hydrocele from solid scrotal masses
• Scrotal ultrasound to confirm fluid accumulation and rule out tumors
• Doppler ultrasound to assess blood flow and detect torsion or infection
• Blood and urine tests to check for underlying infection or inflammation

Imaging helps confirm the diagnosis and plan the appropriate surgical technique.

Surgical Procedure

Open hydrocelectomy is performed under general or spinal anesthesia. The surgeon makes a small incision in the scrotum or lower abdomen, drains the fluid, and then either removes or everts the hydrocele sac to prevent fluid from re-accumulating. The incision is closed with absorbable sutures. The procedure typically takes 30 to 45 minutes and is often done as a day-care surgery.

Hydrocelectomy Procedure Steps

The open hydrocelectomy procedure involves:

• Administration of anesthesia (general, spinal, or local)
• Making a small incision in the scrotum or lower abdomen
• Exposing the hydrocele sac and draining the fluid
• Removing, everting, or plicating the sac to prevent recurrence
• Inspecting the testicle for any underlying abnormality
• Placing a small drain if necessary to prevent fluid buildup
• Closing the incision with absorbable sutures
• Applying a scrotal support bandage for post-operative comfort

After the Surgery

Recovery after hydrocelectomy is generally smooth and quick. Most patients are discharged on the same day or after one night in the hospital. Mild scrotal swelling and bruising are expected for a few days. Patients should wear a scrotal support for 1 to 2 weeks, avoid strenuous activity for 4 weeks, and take prescribed pain medications. Follow-up visits ensure proper healing.

Complications of Hydrocele Surgery

Potential complications of hydrocelectomy include:

• Scrotal swelling and bruising in the early post-operative period
• Hematoma or blood collection in the scrotum
• Infection at the incision site
• Recurrence of hydrocele fluid in rare cases
• Injury to the testicle, epididymis, or vas deferens in rare cases
• Adverse reaction to anesthesia