At the end of pregnancy, the testicles develop, and once the inguinal ring (which is a muscle lining) opens, the testes drop from the abdomen into position. For most boys, this inguinal ring will close, but when it remains open, some fluid can move into the scrotum, causing a hydrocele to form. Hydroceles can also develop with swelling or injury of the scrotum, causing discomfort, an enlarged scrotum, difficulty urinating and sexual functioning.
While most people don't have any signs or symptoms, a baby with a hydrocele may concern parents. For adult men, a hydrocele may cause discomfort and pain. In most cases, a hydrocele will resolve on its own; however, surgery may be performed to correct this issue. A hydrocoelectomy, otherwise known as a hydrocele repair, is done as treatment for a hydrocele in the scrotum if it becomes problematic.
How is a hydrocoelectomy done?
Treatment of a hydrocele can only be done surgically. Your urologist may conduct a physical exam, use imaging tests, do blood and urine tests and shine a light through the scrotum (transillumination) to look for fluid, to make an accurate diagnosis. Depending on the size and whether or not you have had this previously, your urologist will suggest surgery.
In some cases, a hydrocele is caused by an inguinal hernia. If it is caused by a hernia, it is known as a "communicating" hydrocele.
For a "non-communicating" hydrocele, under general anaesthesia, Dr Ridgard will make a small incision into the scrotum and into the hydrocele sac. The hydrocele sac is then drained and cut out. For babies and children with a hydrocele that doesn't resolve on its own, surgery may be done, and the inguinal ring may be stitched closed to prevent a future hernia.
If the hydrocele is "communicating" and there is a related inguinal hernia, an incision will rather be made in the upper groin area so that the hernia can be repaired at the same time. This surgery may be done laparoscopically or through traditional open surgery.
For a larger hydrocele, a drainage tube may be placed through the scrotal skin to drain the sac over time. You will then need to return to the hospital in the next few days to remove the drain.
After surgery you will have a catheter placed for a day or two while you are in hospital. Pain and discomfort can be expected after surgery, but you will be prescribed pain medication for this. You can expect some swelling and bruising for a week or two. You should avoid sex, strenuous activity or heavy lifting for the next few weeks while you recover.