12 April 2011


Definition of Hydrocele

The term hydrocele literally means a sack of water.

A hydrocele is a collection of serous fluid between the two layers of the tunica vaginalis which normally surrounds the testis. This is the most common benign cause of scrotal swelling and has been estimated to occur in as many as 1 percent of the adult male population.


The normal scrotum and testes
The scrotum is normally loose, soft, and fleshy. It holds the two testes. Usually you can easily feel the testes in the scrotum. A tube (the vas) takes sperm from each testis to the the penis. It is normal for one testis to hang lower than the other.
What do hydroceles look and feel like?
A hydrocele feels like a small fluid filled balloon inside the scrotum. It feels smooth, and is mainly in front of one of the testes. They vary greatly in size. Very large hydroceles are sometimes seen in elderly men who have never shown their swelling to a doctor. It might have been getting larger over a number of years.
Hydroceles are normally painless. Large hydroceles may cause discomfort because of their size. Walking or sexual activity may become uncomfortable if you have a very large hydrocele.

Congenital Hydrocele

What is a congenital hydrocele?

A congenital hydrocele is a collection of fluid in the scrotal sac of male infants that drains downward from the abdominal cavity. The baby's scrotum will appear swollen or large, but he will not have other symptoms.

There are two types of congenital hydroceles:

Communicating hydrocele -- This is a hydrocele that has contact (or communication) with the fluids of the abdominal cavity.

Non-communicating hydrocele -- This may be present at birth or may develop years later for no obvious reason. A non-communicating hydrocele usually remains the same size or has a very slow growth.

How can a hydrocele be repaired?
A non-communicating hydrocele usually does not need to be surgically repaired, since it usually goes away spontaneously within
6 to 12 months. A communicating hydrocele needs to be surgically repaired to prevent further complications. The surgery takes about an hour and is usually an outpatient procedure (which means the patient can go home the same day of the procedure).

During the surgery
- An anesthesiologist (a physician who specializes in pain relief) gives your child general anesthesia, which induces sleep.
- A small incision, or cut, (2 cm.) is made in the skin fold of the groin.
- The hydrocele "sac" containing the fluid is identified.
- The surgeon empties the fluid from the sac. The sac is removed.
- The muscle wall is reinforced with stitches to prevent a recurrent hernia or hydrocele.

After the surgery
Most children will be able to go home a few hours after surgeryCaring for your child after surgery
Usually, your child will feel fine again the evening after surgery or by the next morning. As soon as your child is able, he can resume normal eating habits and activities. You may give your child a sponge bath the day after surgery. Tub baths are permitted two days after surgery.

Treatment in adults
Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they threaten the testicule's blood supply.One option is to remove the fluid in the scrotum with a needle (a process called aspiration). However, aspiration can cause infection, and it is common for the fluid to re-accumulate. Therefore, aspiration is not routine and surgery is generally preferred. On the other hand, aspiration may be the best alternative for people who have certain surgical risks.Injection of sclerosing (thickening or hardening) medications may be performed after needle aspiration to close off the opening through the scrotal sac. This helps prevent re-accumulation of fluid. The medications include tetracycline, sodium tetradecyl sulfate, or urea. Possible complications after aspiration and sclerosing include infection, fibrosis, mild to moderate pain in the scrotal area, and recurrence of the hydrocele.

Hydrocelectomy is often performed to correct a hydrocele. This is a minor surgical procedure performed on an outpatient basis using general or spinal anesthesia. An incision may be made in the scrotum or the lower abdomen.

The procedure may require a scrotal drainage tube or a large bulky dressing to the scrotal area. You will be advised to wear a scrotal support for some time after surgery. Ice packs should be kept to the area for the first 24 hours after surgery to reduce the swelling in the area.

Possible complications of this procedure include hematoma (blood clot formation), infection, or injury to the scrotal tissue or structures.

Hydroceles associated with an inguinal hernia should be repaired surgically as quickly as possible. Hydroceles that do not resolve spontaneously over a period of months should be evaluated for possible surgery.

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