A hydrocele is normally a benign disorder in which fluid fills the scrotum and causes swelling to occur. This swelling grows over time as the fluid continues collecting in the scrotum.
Rachit Bansal, 42, was one of many adults who had been ignoring the swelling in his scrotum for a long time. He approached the doctor only when he started experiencing discomfort.
Rachit decided to consult Dr. Amarchand S. Bajaj, Senior Consultant (Laparoscopic, Bariatric & General Surgery) at Sitaram Bhartia Hospital, South Delhi.
He underwent a physical exam where his groin was examined. It was discovered that Rachit had developed a hydrocele as his scrotum was filled with fluid and that was causing swelling and discomfort.
In order to better understand what the problem was, Rachit decided to get all his doubts addressed at his consultation with Dr. Bajaj and put forth his questions.
Why does hydrocele happen?
“Patients often mistake the condition with groin injuries. The truth, however, is that hydroceles may be primary (idiopathic) or secondary in nature. This means there may be no causes for hydrocele,” said Dr. Bajaj.
A primary hydrocele may be congenital in nature, formed due to excessive production of fluid within the scrotal sac or due to defective absorption of fluid.
A secondary hydrocele is usually associated with inflammatory conditions like Epididymo-orchitis. They may also be present with testicular tumours (malignancy).
Hydroceles occur in about 5% of male newborns and 1% of male adults, usually after 40 years of age.
Most of the time men do not experience any symptoms if the hydrocele is small in size. This is often the reason patients seek treatment when their swelling is considerably large.
As the swelling grows, however, you may start experiencing:
- Enlargement of the scrotum
- A feeling of heaviness or discomfort in one or both sides
- Pain that could indicate infection or testicular torsion (testicle getting twisted)
Will hydrocele go away by itself?
“Hydroceles in adults cannot disappear on their own as the fluid increases over time and enlarges the size of the sac. Large hydroceles will need to be further evaluated and have to be surgically removed.”
Rachit’s condition had been worsening over the months. He asked the doctor if his condition could result in complications if hydrocele surgery was delayed.
Is a hydrocele dangerous?
Typically, hydrocele is not dangerous in men and has no effect on their fertility.
“We, however, keep an eye on adults with this condition as it may be an indication of underlying testicular conditions. Sometimes, due to the presence of fluid in the scrotum, you may be more liable to developing an infection.”
Rachit was suggested an ultrasound and some blood tests in order to rule out these complications. He returned a few days later for follow-up consultation and, much to his relief, he hadn’t developed an infection.
Dr. Bajaj recommended surgery as the swelling in Rachit’s scrotum was large and steadily increasing over time. He encouraged Rachit to clear his doubts regarding hydrocele treatment if he was still unsure about the operation.
How can I treat my hydrocele at home?
Hydrocele treatment at home is not recommended by doctors.
It is important to note that ‘Trial of Aspiration’, or draining the fluid using a needle, is a temporary procedure that relieves symptoms may be only for a week and increases the chances of infection. It should only be attempted in inoperable cases or if the patient is unfit for surgery.
Patients like Rachit who develop larger hydroceles are suggested surgery as early as possible.
How do you fix a hydrocele?
Hydrocelectomy is a procedure used to treat hydroceles. It can be performed in various ways, i.e. through plication, eversion and excision.
What is a hydrocelectomy procedure?
An incision or small cut is made in the scrotum and the accumulated fluid is then drained. The hydrocele sac is then turned inside-out and secured using sutures.
Is hydrocele surgery painful?
The repair involves the use of small cuts along with anesthesia and so results in a short, painless surgery.
How long does hydrocele surgery take?
A hydrocelectomy takes less than an hour.
“Are there any complications with a hydrocelectomy?” Rachit asked.
A hydrocele repair is mostly safe. There are very low chances of complications or infection. There may be some swelling in the scrotum after a hydrocelectomy but that is normal.
Rachit felt at ease when he heard that.
He inquired about the recovery time after a hydrocelectomy.
“The procedure is a day-care operation and so you do not need to stay overnight at the hospital and can recover quicker as well. You will also be able to avoid multiple post-operative visits as the sutures we use at our hospital are absorbable and hence, there is no pain of removing sutures,” reassured Dr. Bajaj.
At his words, Rachit began feeling more confident about the surgery. He understood that wasting any more time by not receiving treatment was causing him more harm than good.
Preparing for Hydrocele Operation
He went on to ask, “How should I prepare for a hydrocelectomy?”
“You will need to undergo a pre-anesthetic checkup wherein the anesthesiologist will counsel you about the procedure, take a detailed history and ask about any allergic reactions to anesthesia,” informed Dr. Bajaj.
“You may also need to get routine blood and urine tests done.”
“As with other surgeries, you will need to fast 6-8 hours before the procedure and inform us of any medication that you are taking so that if needed, it can be discontinued prior to the removal.”
Rachit decided to go ahead with the hydrocelectomy and scheduled a date with the doctor.
The operation was carried out successfully and he was discharged on the same day. He was advised to avoid any demanding activity and to resume work after 3 days. At his post-op checkup later, Rachit expressed his satisfaction with his decision as he had already started feeling much better!
Come in for a complimentary consultation with Dr. Amarchand Bajaj. Please call us on +9871001458 to schedule a free consultation.
This article was originally written in 2019 with inputs from Dr. Amarchand S. Bajaj, who has over 17 years of experience as a laparoscopic, general and bariatric surgeon. He is known to be a skilled surgeon who takes the time to listen to patients’ complaints and treat them accordingly.
The article has been updated in 2020 for comprehensiveness and detail.
Medically reviewed by Dr. Amarchand S. Bajaj
MBBS, Govt. Medical College, Nagpur (1997), M.S. (General Surgery), Govt. Medical College, Nagpur (2003)