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Hydrocele repair

Definition

Hydrocele repair is surgery to correct the swelling of the scrotum that occurs when you have a hydrocele. A hydrocele is the backup of fluid in a testicle.

Baby boys sometimes have a hydrocele at birth. Hydroceles also occur in older boys and men. Sometimes they form when there is also a hernia (an abnormal bulging of tissue) present. Hydroceles are fairly common.

Alternative Names

Hydrocelectomy

Description

Surgery to repair a hydrocele is often done at an outpatient clinic, not a hospital. The patient will receive general anesthesia and will be unconscious and unable to feel pain during the procedure.

In a baby or child:

• The surgeon makes a small surgical cut in the fold of the groin, and then drains the fluid. The sac (hydrocele) holding the fluid may be removed. The surgeon then strengthens the muscle wall with stitches. This is called a hernia repair.
• Sometimes the surgeon uses a laparoscope to do this procedure. A laparoscope is a tiny camera the surgeon inserts into the area through a small surgical cut. The camera is attached to a video monitor in the room. The surgeon makes the repair with small instruments that are inserted through other small surgical cuts.

In adults, the cut is usually made on the scrotum. The surgeon then drains the fluid after removing part of the hydrocele sac.

Why the Procedure Is Performed

Hydroceles often go away on their own in children, but not in adults. Most hydroceles in infants will go away by the time they are 2 years old.

Your surgeon may recommend hydrocele repair if:

• The hydrocele becomes too large
• The hydrocele causes problems with blood flow in the area
• There is also a hernia present

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Infection
• Blood clots

Before the Procedure

An anesthesiologist (a doctor who specializes in pain control and giving pain medicines) will talk with you about your or your child’s medical history. This information will help the anesthesiologist choose the right amount and type of anesthesia (pain medicine) to use.

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Also tell your doctor if you have any allergies or if you have had bleeding problems in the past.

Several days before surgery, adults may be asked to stop taking aspirin or other drugs that affect blood clotting. These include ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), some herbal supplements, and others.

You or your child may be asked to stop eating and drinking at least 6 hours before the procedure.

Take the medicines your doctor told you take with a small sip of water.

After the Procedure

Patients usually recover quickly. Most can go home a few hours after surgery. Children should take it easy and rest more than usual the first few days after surgery. Normal activity can usually start again in about 4 to 7 days.

Outlook (Prognosis)

The success rate for hydrocele repair is very high. The long-term prognosis is excellent, but another hydrocele may form over time, or if there was also a hernia present.

References

Schneck FX, Bellinger MF. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 127.

Aiken JJ, Oldham KT. Inguinal hernias. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 343.