Hydrocele Surgery (Hydrocelectomy) Treatment: Effective Relief from Scrotal Swelling at Minnerva Clinic

A hydrocele develops when there's an imbalance between fluid production and absorption within the sac around the testicle.

Types of Hydrocoeles:

• Communicating Hydrocele: More common in infants, this occurs when the passage between the abdomen and the scrotum (processus vaginalis) fails to close completely, allowing abdominal fluid to drain into the scrotum. The swelling may fluctuate in size.
• Non-Communicating Hydrocoele: More common in adults, this develops when the sac closes but the body either produces too much fluid or doesn't absorb it properly. It can also occur due to inflammation, infection (epididymitis, orchitis), or injury to the testicle or epididymis.

Symptoms of a hydrocele include:

• Painless swelling of one or both sides of the scrotum.
• A feeling of heaviness or dragging in the scrotum.
• Discomfort, especially if the hydrocele becomes very large.
• In infants with a communicating hydrocele, swelling may increase during the day and decrease at night.

How Hydrocele Surgery (Hydrocelectomy) Works:

Hydrocelectomy is a surgical procedure designed to remove the hydrocele sac or alter it to prevent fluid from re-accumulating.

• Anesthesia:
  • Adults: Usually performed under regional (spinal) anesthesia or general anesthesia. Local anesthesia with sedation may be an option for smaller hydrocoeles.
  • Children: Always performed under general anesthesia.
• Incision: A small incision is made in the scrotum or sometimes in the groin (especially for communicating hydrocoeles in children).
• Fluid Drainage & Sac Management: The surgeon carefully exposes the hydrocoele sac and drains the accumulated fluid. The key part of the surgery involves dealing with the sac itself to prevent recurrence:
  • Excision of the Sac: A portion or all of the hydrocoele sac (tunica vaginalis) is removed.
  • Eversion or Plication of the Sac (Lord's or Jaboulay's Procedure): The sac is opened, turned inside out (everted), and sutured behind the testicle, or it is stitched (plicated) to reduce its size and prevent fluid from collecting.
• Closure: The incision is closed with absorbable sutures, so stitch removal is usually not necessary. A small drain may be temporarily placed in some cases.
• Dressing & Support: A sterile dressing and a scrotal support (jockstrap or supportive underwear) are applied.

Hydrocelectomy aims to:

• Permanently resolve the scrotal swelling caused by the hydrocele.
• Alleviate any associated discomfort or heaviness.
• Prevent recurrence of the hydrocele.
• Rule out any other underlying testicular pathology if an exploration is part of the procedure.

During your physical examination, your surgeon will differentiate the soft, fluid-filled sac of a hydrocele from other scrotal conditions, such as a varicocele, which involves enlarged veins and is addressed with varicocele surgery.

Hydrocoele surgery is often recommended when a hydrocoele is large, symptomatic, persistent, or causes concern. This surgical option might be suitable if:

For Adults:

• You have a large or tense hydrocele causing discomfort, heaviness, pain, or embarrassment.
• The hydrocele has been present for a long time (e.g., more than 6-12 months) without spontaneous resolution.
• There is any uncertainty about the diagnosis, or if an underlying testicular issue needs to be ruled out (though this is usually done with an ultrasound before elective surgery).
• You desire a definitive and permanent solution.

For Children (Communicating Hydrocoeles):

• The hydrocele persists beyond 12-18 months of age (many resolve spontaneously before this).
• The hydrocele is very large, tense, or causing discomfort.
• There is an associated inguinal hernia that also requires repair.

General Considerations:

• The individual (or child, via parents) is in good general health for surgery.
• You have realistic expectations about the procedure, recovery, and potential (though usually minimal) scarring.

Not all hydrocoeles require surgery. Small, asymptomatic hydrocoeles in adults may be monitored. In infants, many communicating hydrocoeles resolve on their own within the first year or two of life. A thorough consultation at Minnerva Clinic is essential. Our urologists or surgeons will perform an examination (often with an ultrasound), discuss your symptoms, and advise on whether surgery is the most appropriate course of action for you or your child. A hydrocele must be correctly distinguished from an inguinal hernia, which can also present as swelling in the groin or scrotum. Our expert surgeons are skilled in accurately diagnosing both conditions and, if needed, performing hernia surgery treatment.

• ✔️Experienced Urologists & Surgeons: Our surgical team includes specialists highly skilled in performing hydrocelectomy for both adult and pediatric patients, ensuring precise and effective treatment.
• ✔️Focus on Definitive Resolution & Preventing Recurrence: We utilize proven surgical techniques designed to permanently correct the hydrocoele and minimize the chances of it returning.
• ✔️Safe Surgical Environment & Appropriate Anesthesia: All procedures are conducted in a sterile, accredited facility with appropriate anesthesia administered and monitored by qualified professionals to ensure patient safety and comfort.
• ✔️Personalized Care for Adults & Children: We tailor our approach to the specific needs of each patient, whether an adult seeking relief or a child requiring gentle, specialized care.
• ✔️Minimally Invasive Incisions for Optimal Healing: Surgeons aim to make small, well-placed incisions to reduce scarring and promote quicker recovery.
• ✔️Comprehensive Consultation and Clear Aftercare Guidance: We ensure you (and parents, if applicable) are fully informed about the procedure and receive detailed instructions for a smooth post-operative course.