A hydrocele may seem like a simple medical issue: a fluid-filled sac around the testicle that causes swelling in the scrotum.

But for many men, this condition can bring more than just physical discomfort; it can lead to emotional distress, embarrassment, and a sense of insecurity.

While hydroceles are usually not dangerous, their persistence or growth often leads to the consideration of surgery.

Worried about the safety of Hydrocele surgery? Concerned about the potential risks, and how successful is the procedure in delivering long-term relief?

This guide by Mykare Health will give you everything you need to know about hydrocele surgery.

Understanding about Hydrocele

A hydrocele is a condition where there is an accumulation of clear fluid in the sac around the testicle, leading to swelling in the scrotum.

It typically presents as a painless, soft, and smooth enlargement of the scrotum. While it can occur at any age, it is more common in newborns and older adults.

When Is Hydrocele Surgery Necessary?

Hydrocele surgery is typically recommended when the condition causes pain, discomfort, or significant swelling. Surgery may also be considered in the following situations

• Large Hydroceles: If the hydrocele is large enough to cause significant discomfort or emotional distress due to the enlarged scrotum.

• Pain or Discomfort: If the hydrocele causes persistent pain, pressure, or a feeling of heaviness in the scrotum.

• Risk of Complications: If there are concerns about the hydrocele leading to more serious complications such as infection or impaired blood flow to the testicle.

• Hydrocele in Adults: In adults, particularly those with a non-communicating hydrocele, surgery is often the treatment of choice because it does not resolve on its own and can be a source of discomfort.

• Infant Hydrocele: In some cases, a hydrocele in infants may not resolve on its own and may require surgical intervention.

Hydrocele Surgery: What to Expect

Hydrocele surgery, also known as hydrocelectomy, is the procedure used to remove the fluid-filled sac surrounding the testicle. The surgery is typically performed under general anesthesia or regional anesthesia, depending on the patient's condition and the surgeon's recommendations.

There are two main types of hydrocele surgery

1. Open Hydrocelectomy

This is the traditional approach, where the surgeon makes an incision in the scrotum or lower abdomen to access and remove the fluid-filled sac. The surgeon will also close off any connections to the abdominal cavity (in the case of a communicating hydrocele). The incision is closed with stitches, and the patient is monitored for recovery.

2. Minimally Invasive Hydrocelectomy (Laparoscopic or Video-Assisted Surgery)

Laparoscopic or video-assisted hydrocelectomy involves making several small incisions in the abdomen, through which a camera and specialized instruments are inserted to remove the hydrocele. This technique is less invasive, and patients tend to experience less pain, a shorter recovery period, and smaller scars. However, not all cases of hydrocele are suitable for laparoscopic surgery, and the decision is made on a case-by-case basis.

Both types of surgery are highly effective in removing the hydrocele, with the open technique being more commonly performed.

Benefits of Hydrocele Surgery

Hydrocele surgery offers several important benefits for patients, including

1. Relief of Symptoms

The primary benefit of hydrocele surgery is the relief of symptoms, particularly if the hydrocele is causing pain, pressure, or discomfort. By removing the fluid-filled sac, the surgery can significantly improve a patient's quality of life and eliminate the uncomfortable swelling in the scrotum.

2. Improved Aesthetic Appearance

For many men, the cosmetic appearance of the scrotum is a significant concern. A large hydrocele can lead to a visibly enlarged scrotum, which may cause self-consciousness or embarrassment. Hydrocele surgery can restore a more natural appearance to the scrotum, enhancing the patient's self-esteem.

3. Prevention of Complications

If a hydrocele is left untreated, there is a risk that it could lead to complications such as infection, testicular atrophy, or impaired blood flow. Hydrocele surgery helps prevent these potential complications by removing the fluid-filled sac and addressing any underlying issues, such as a hernia.

4. Treatment of Underlying Conditions

In some cases, a hydrocele may be a symptom of an underlying condition, such as a hernia or infection. Surgery to remove the hydrocele may also address the root cause of the problem, thereby preventing further health issues.

5. Relatively Low Risk of Recurrence

When performed by an experienced surgeon, hydrocelectomy has a relatively low risk of recurrence. Most patients experience long-term relief from their symptoms after surgery, with minimal chances of the hydrocele returning.

Risks and Potential Complications of Hydrocele Surgery

While hydrocele surgery is generally safe and effective, there are certain risks and potential complications that patients should be aware of

1. Infection

As with any surgical procedure, there is a risk of infection following hydrocele surgery. Infections can occur at the site of the incision and may require additional treatment, including antibiotics or drainage of the infection.

2. Bleeding and Hematoma

Some bleeding is common after surgery, but excessive bleeding can lead to the formation of a hematoma (a collection of blood outside the blood vessels). In most cases, a hematoma resolves on its own, but in some cases, further intervention may be needed.

3. Scarring

Although the scars from hydrocele surgery are generally small, there is still a risk of scarring at the incision site. In some cases, scarring may cause discomfort or result in cosmetic concerns. The risk of scarring can be minimized by choosing a skilled surgeon who uses appropriate surgical techniques.

4. Testicular Damage

There is a small risk of accidental injury to the testicle during surgery, which could lead to complications such as testicular atrophy or loss. However, this risk is minimal, and the procedure is usually performed with great care to avoid any damage to the testicle.

5. Recurrence of the Hydrocele

Although the risk is low, there is a chance that the hydrocele may recur after surgery. This is more common in cases where the hydrocele was large or had been present for a long time. Recurrence can sometimes be treated with additional surgery.

6. Anesthesia Risks

Like any surgery performed under general anesthesia, hydrocele surgery carries the risk of complications related to anesthesia, such as allergic reactions, breathing difficulties, or heart complications. However, these risks are rare and are carefully managed by the anesthesia team.

Success Rates of Hydrocele Surgery

The success rate of hydrocele surgery is generally high, with most patients experiencing significant improvement in symptoms and no recurrence of the hydrocele. Success rates can vary depending on factors such as the type of hydrocele (communicating vs. non-communicating), the size of the hydrocele, the technique used, and the surgeon's skill.

In general

• Open hydrocelectomy has a success rate of approximately 95-98%, with most patients reporting a significant reduction in scrotal swelling and no recurrence of the hydrocele.

• Minimally invasive hydrocelectomy may have slightly higher success rates due to the smaller incisions and faster recovery times, but the difference in success rates is usually minimal.

Patients who follow their surgeon’s postoperative instructions carefully and attend follow-up appointments are more likely to experience a successful outcome.