What is a Hydrocele?
A hydrocele is an accumulation of fluid in the scrotal sac which normally contains the male testicle. It is usually a benign condition which may be found in newborns, young boys and even in adults. The cause is unknown, especially in 10 percent of newborn males, but in adults it may be related to trauma, infection or inflammation within the scrotum. The result is an enlarged, painless scrotal swelling that usually disappears in the first year after birth, although in adults it may not go away without intervention.
Since hydroceles are not usually serious they may be left alone and observed for changes. However, in a few cases in adults they may cause pain and discomfort, and may compromise blood circulation to the penis and testicles. Needle aspiration or surgical intervention is therefore indicated to remove the fluid and repair an abdominal wall defect if present.
Simple needle aspiration of the scrotal fluid may temporarily relieve the patient’s discomfort but fluid accumulation may recur if there is an existing abdominal wall defect. In these cases, repair may be done to remove the fluid sac, seal the defect to strengthen the wall and prevent fluids in the abdominal compartment from seeping into the scrotal sac. This procedure is called a hydrocelectomy.
Surgical repair of hydroceles are usually done as an outpatient. The patient may be sent home after recovering from anesthesia unless complications arise. These complications are usually minor and are common to other minor and major surgeries such as:
- Severe pain
- Blood clots
Swelling After Hydrocelectomy
Severe swelling after hydrocele surgery may be prevented by surgically inserting a small drainage tube in the scrotum. This is then covered by a bulky dressing to compress the site.
Swelling normally occurs after hydrocelectomy and may last for months. However it may be reduced through the following means:
- Applying ice packs intermittently over the surgical site for 24 hours.
- Wearing of scrotal support for a few days after hydrocelectomy.
- Jockey-type underwear, rather than boxer shorts are more helpful in holding the dressings in place.
- Taking nonsteroidal anti-inflammatory drugs to reduce pain, inflammation and swelling.
- Bathing is allowed but dressings must be removed and changed after each shower. The steristrips or strips of adhesive tape over the incision may be left in place, but the area must be pat dry after bathing.
- Constipation must be avoided to prevent straining which increases abdominal pressure and swelling. Foods that are rich in fiber and adequate hydration are recommended.
- Although one may usually return to normal activities such as driving, walking and climbing stairs, it is better to avoid strenuous activities until swelling subsides. For children, rough play must be avoided.
Although swelling may be harmless, one must watch out for symptoms that should necessitate medical consultation such as:
- High fever (a temperature higher than 101°F) which is not relieved after one day of taking analgesics or antipyretics
- Continuous drainage or fluid from the surgical incision
- Red and swollen incision site
- Inability to urinate
- Severe pain
These may be signs of ongoing infection and require immediate medical attention.
Mayo Clinic, “Hydrocele Treatments and Drugs”, https://www.mayoclinic.com/health/hydrocele/DS00617/DSECTION=treatments-and-drugs
South Island Surgical Centre, “Hydorcoele – Adult”, https://www.southislandsurgical.com/Pro%20Hydro.htm