What is a hydrocele?
A hydrocele is a scrotal swelling due to a collection of fluid around the testicle. It may affect one or both sides of the scrotum.
What causes a hydrocele?
Between the muscles in the groin is a narrow passageway called the inguinal canal. This canal contains blood vessels going to and from the testicle and the tube that transmits sperm from the testicle (the vas). The canal also contains a small tube-like extension of the lining of the tummy (which looks like ‘Gladwrap’) that passes down to the testicle. The tube is open at birth but usually closes within a few months. If it stays open, fluid from the tummy can trickle down and collect around the testicle, causing a scrotal swelling.
Can a hydrocele get better without an operation?
Yes. The small tube-like connection between the tummy and the scrotum can still close by itself up to two years of age. After this age a hydrocele rarely disappears completely (although the swelling may come and go) and surgery is the only way to fix it.
Does a hydrocele have to be repaired?
Hydroceles are not painful or dangerous and they don’t interfere with future fertility but they tend to get bigger slowly. The operation is not urgent unless your child has a groin hernia as well as a hydrocele.
What does the operation involve?
The operation is very similar to repair of a groin hernia and involves a short general anaesthetic. Once your child is ‘asleep’ the surgeon makes a small cut in a skin crease in the groin and finds the thin tube-like connection between the tummy and the scrotum. This tube must be separated from the blood vessels and vas passing to and from the testicle. The tube is then tied off. The skin is closed with dissolving stitches and a clear plastic dressing put on the wound. A locl anaesthetic injection is often given during the operation to reduce soreness after the operation.
Repair of a hydrocele on one side usually takes about 15 minutes. Your child will be in the operating theatre for longer because it takes time to safely put him to sleep and to wake him from the anaesthetic. After the operation he will be transferred to a recovery area where you will be able to join him.
Are there any complications
of the operation?
Repair of a hydrocele is a common and straightforward operation and complications are uncommon. Possible complications include:
- Complications of the anaesthetic
Your anaesthetist is the best person to discuss these.
2. General complications of any operation
Bruising around the wound or in the scrotum or infection in the wound are rare. You should see your family doctor if the wound becomes red or increasingly painful.
- Specific complications of the operation
- A recurrent hydrocele; if the tube is not tied off completely, the swelling may recur needing a further operation.
- Damage to nearby structures during the procedure such as nerves (which can cause temporary numbness of an area of groin skin) or the blood vessels or sperm tube (vas) connected to the testicle. Damage to the testicular blood vessels or vas can cause the testicle to shrink and impair sperm production. Fertility will then depend on the other testicle working normally.
When will my child be able to go home after the operation?
The operation is usually carried out as a ‘day case’ so that your child is able to go home later the same day. You will be advised to give him regular doses of a painkiller such as Paracetamol during the first 24 hours after the operation.
When can my child resume normal activities?
Boys recover quickly after a hydrocele repair. They can have a quick bath or shower the next day. The plastic dressing can be peeled off if it is still there after a week. Older children can usually get back to school after a few days and return to sports about 2 weeks after the operation. The general rule is “if it hurts, stop and wait a bit longer before trying again”.