WHAT IS A HYDROCELE?
A Hydrocele is a collection of fluid around the testicle. Hydroceles are common and 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, usually non-tender and is often, bluish in colour. The right side is more commonly involved.
Hydroceles (non-communicating) may also be caused by:
- Build up 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 include:
- Round-oval shaped swelling of one or both testicles, which feels like a water balloon.
- 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 size. Sometimes, the swollen area might be smaller in the morning and larger later in the day.
WHAT DOES THE SURGERY 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 holds the fluid using absorbable stitches, to prevent the fluid form re-forming.
Sometimes, we 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.
WHAT CAN I EXPECT WHEN I GET HOME?
- You will 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 (and may appear that the hydrocele has recurred)
- 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
- Any dressing should fall off within 48 hours; if not or it becomes soaked with urine, remove it
- Try to keep the area dry for 24 to 48 hours; avoid soaking in a bath
- You should not swim for one-two weeks
- You are encouraged to wear supportive underwear to help reduce the swelling and to provide you with some scrotal support
- 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 as otherwise told by your surgeon
WHAT ARE THE POSSIBLE COMPLICATIONS?
- 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
NOTIFY GM UROLOGY or your GP if you experience any of the following:
- Heavy bleeding or any wound discharge
- Significantly increased swelling or bruising of the scrotum
- Redness, soreness or pus around the wound
- Wound coming undone
- Increased discomfort, severe pain
- Fevers (temperatures over 37.5 degrees), sweats or shakes