What Is Hydrocele Treatment

Normal and abnormal hydrocele treatment

Hydrocele is the accumulation of fluids around the testicle and is the cause of noticeable swelling on one or both sides of the scrotum. This is a benign disorder that does not entail a risk of infection or of worsening into a serious disease.

It can, however, cause discomfort, lead to the inability to engage in certain activities and be esthetically displeasing.

The surgical intervention aims to restore the scrotum to its normal size and to eliminate the symptoms which brought you to the consultation room.

Are There Other Treatment Possibilities?

There is no medical treatment for hydrocele.

It is sometimes possible to treat hydrocele by draining or by the injection of a sclerosing agent but the risk of recurrence after these treatments is high and subsequent surgical treatment becomes more difficult. These forms of treatment are seldom performed in Quebec.

What to Do Before Hydrocele Treatment

In hospital, the intervention is performed under general or spinal anesthesia. As with all surgical procedures, a consultation at the pre-admission clinic is necessary a few days before the operation. The shaving of the scrotum must be performed the morning of the operation. You must fast from midnight the previous day.

In private practice, the intervention takes place under local anesthetic with a spermatic cord block. An hour before the procedure, a sublingual Ativan is given to help relax the patient and to promote the oral anesthetic. It is preferable to have eaten a light breakfast.

How Is Hydrocele Treatment Carried Out?

The intervention is performed by making a short incision at the level of the brown line of the scrotum. The first step is to drain the fluid. Next, part of the envelope must sometimes be excised and then reconfigured, in order to reduce the risk of recurrence. Absorbable sutures are then used to close the skin.

A drain is sometimes left in place temporarily.

What to Do After Hydrocele Treatment

  • The first day should be a day of complete rest. The day after the surgery and for the first week, walking is permitted, but should be done progressively alternating between 30 minute periods of activity and periods of rest.
  • Wear fitted underwear day and night for greater comfort.
  • For the first week, avoid overexertion and any activities that cause pain.
  • Apply an ice pack surrounded by a towel to the scrotum for 20 minutes every hour, as needed. The cold helps decrease the swelling and relieve pain.
  • Avoid sports for 15 days.
  • Wait about 15 days before resuming sexual activity.
  • Avoid the use of stairs where possible.
  • Avoid constipation.
  • If a drain was put in place, it will be removed in the first few post-operative days; the pain near the incision is usually minimal and temporary.

An appointment to monitor recovery is scheduled two months after the intervention.

What Are the Risks and Complications?

All surgical intervention entails certain risks that cannot always be foreseen. Certain complications occur exceptionally that sometimes cannot be healed.

In the course of this intervention, the surgeon may be faced with a discovery or an unforeseen situation that requires a different course of action than what was originally planned, if not requiring a complete halt to the surgery.

Certain complications can be related to your general state or to the anesthesia; they will be explained to you during the pre-operative consultation with the anesthesiologist and are possible occurrences during any surgery.

Other complications that are directly related to the operation are rare, but possible:

  • Hematoma: a re-intervention to stop the bleeding and drain the hematoma may be necessary.
  • Late scarring may require prolonged local treatments.
  • Infection: the presence of fluid leaking from the incision, signs of general infection such as fever or of local infection such as inflammation of the bursa can require antibiotic treatment or the treatment of an eventual abscess by Dr. Marois.
  • Testicular atrophy: this is a very rare occurrence after hydrocele treatment.
  • Recurrence: the risk is very low.

It is possible for the scrotum to be bluish or blackish for a few days. This is normal, and everything will return to normal after 2 or 3 weeks. Absorbable sutures are used, and will absorb on their own in 12 to 15 days.

When the sutures are absorbed, there can be discharges that look like pus. Take a bath every day. Showers are allowed after 24 hours and baths after 48 hours.

What to Watch Out for After Hydrocele Treatment

  • Watch for redness or discharges from the incision or the penis, and for whether scrotal swelling increases.
  • Watch for the presence of fever, that is, for oral temperatures that are above 38°C and persist for more than 48 hours.
  • If you observe such signs, you must advise the secretary at Dr. Marois’ office (she will contact your doctor if need be).
  • If you are worried and your state does not improve, go to the nearest emergency room.

How Long Is the Convalescence Period?

Recovery lasts between a few days and 1 month, depending on your state of health. Your return to work depends mostly on the type of work you do (that is, whether or not strenuous physical exertion is a requirement of your work).

If any complication or problem occurs outside our business hours, or if you are not able to join a secretary to make an appointment, please report to Verdun Hospital Emergency. The emergency physician will try to join Dr. Marois to get his report. Dr. Marois will then be able to give his recommendations over the telephone or will come to see you directly at the emergency room.

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