Hydrocele

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Hydrocele

Male reproductive anatomy

Processus vaginalis; Patent processus vaginalis

Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or when they get large enough to threaten the testicle'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.

Sclerosing (thickening or hardening) medications may be injected 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 scrotum, and recurrence of the hydrocele.

SURGERY

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 cut 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 on the area for the first 24 hours after surgery to reduce the swelling.

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 on their own over a period of months should be evaluated for possible surgery.

Generally, a simple hydrocele goes away without surgery. If surgery is necessary, it is a simple procedure for a skilled surgeon, and usually has an excellent outcome.