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Hydrocele Repair

A PATIENT INFORMATION SHEET

What is a Hydrocele?

A Hydrocele is a collection of fluid around the testicle.

Hydroceles are common cystic scrotal abnormalities, described as a fluid‐filled collection around the testicles, between the visceral and parietal layers of the tunica vaginalis of the scrotum. Hydroceles are responsible for most painless scrotal swellings. A communicating hydrocele is common in newborns and usually disappears without treatment by age 1. These are congenital and similar to hernias. Older boys and adult men can develop a non-communicating hydrocele due to inflammation or injury within the scrotum. The scrotum appears enlarged with fluid; it may be very tense, is usually non-tender and is often, bluish in color. The inguinal canal is normal.

Hydroceles (non-communicating) may also be caused by:

  • Buildup of the normal fluid around the testicle. This may occur because the body makes too much of the fluid or it does not drain well
  • Swelling or injury of the testicle or epididymis

Hydrocele symptoms:

  • Usually, the only indication of a hydrocele is a painless round-oval shaped swelling of one or both testicles, which feels like a water balloon. The right side is more commonly involved
  • The scrotum is swollen, but not painful to the touch. Often, the testicle cannot be felt because of the fluid around it.
  • Hydroceles can be easily seen by shining a flashlight through the swollen part of the scrotum. If the scrotum is full of clear fluid, the scrotum will light up.
  • Adult men with a hydrocele might experience discomfort from the heaviness of a swollen scrotum. Pain generally increases with the size. Sometimes, the swollen area might be smaller in the morning and larger later in the day.

What does this procedure involve?

Removal or repair of a fluid sac surrounding your testicle, to prevent further fluid developing. The procedure can be done under either a general anaesthetic or a spinal anaesthetic (where you are unable to feel anything from the waist down). A small incision is made into your scrotum and the fluid is drained away from around your testicle. During the procedure your surgeon will “bunch up” the sac which hold the fluid using absorbable stitches, to prevent the fluid form re-forming. Sometimes, they will remove the majority of this sac as well. Your testicle will always feel bulkier than the other, unaffected testicle. The wound is then closed with dissolvable stitches which will disappear after 2-3 weeks.

Potential risks / side effects

  • Swelling, discomfort and bruising of your scrotum lasting several days
  • Bulky feeling around the testicle due to the “bunched up “-hydrocele sac
  • Blood collection (haematoma) around the testicle which usually resolves slowly and may need surgical removal if very large / uncomfortable
  • Infection in the incision or testicle requiring antibiotics or surgical drainage
  • Recurrence of the hydrocele (fluid collection)
  • Chronic pain in your testicle or scrotum

Before the operation

  • If you are taking any medication for diabetes you must contact our rooms for advice at least 1 week prior to procedure.
  • If you are on any blood thinning medication you must notify and discuss with your Urologist to see if you need to stop taking prior to your operation. You are also advised to discuss stopping these medications with your GP/Physician.  We ask you to stop these medications as they can increase your risk of bleeding during/after the operation. Some examples are listed below:
  • If you are on Aspirin, Plavix, Iscover or Asasantin you will need to stop taking these medications 7-10 days before the operation.
  • If you are taking Xarelto or Eliquis (Apixaban) you must stop this 3 days before surgery.
  • If you are taking Brilinta (Ticagrelor) you must stop this 10 days before surgery.
  • If you take Warfarin or Pradaxa, this must be stopped 5 days before surgery.
  • Other medications such as Voltaren, Brufen, Mobic and natural therapies such as garlic should also be discussed with your doctor as they can increase the risk of bleeding.

What can I expect when I get home?

  • You get some bruising of the scrotum which will likely last a few days
  • You will get some swelling of the scrotum which will likely last several weeks
  • You are encouraged to wear supportive underwear to help reduce the swelling and to provide you with some scrotal support
  • Take regular analgesia such as Panadol. We recommend you don’t take any anti-inflammatory tablets e.g. Nurofen for the first 48 hours as this can increase bleeding
  • Your stitches will be dissolvable and will usually disappear after 2-3 weeks
  • You should avoid heavy lifting or any other strenuous exercise for at least 4 weeks or otherwise told by your surgeon

NOTIFY GEELONG UROLOGY if you experience any of the following

  • Fevers (temperatures over 37.5 degrees), sweats or shakes
  • Increased discomfort, severe pain
  • Heavy bleeding or any wound discharge
  • Unable to pass urine
  • Cloudy or offensive urine

FOLLOW UP APPOINTMENT

You will need an appointment for approximately 6 weeks after your surgery. If an appointment time is not given to you on discharge from hospital, you will need to phone Geelong Urology to make an appointment with your surgeon.

Geelong Urology 03 5229 9105 during business hours

Or leave a message on the After-Hours Urology Paging Service 03 9387 1000