HYDROCELE

What is a Hydrocele ?

A hydrocele is a collection of fluid around the testicle. This gives the appearance of a swelling of the scrotum, the bag (or sac) in which the testis rests. The condition may occur on one or both sides. Normally there is a small amount of fluid surrounding the testicle but if the amount of fluid increases, a spherical swelling becomes evidence on one side of the scrotum. This is usually painless, although sometimes the fluid is produced because of infection of the testicle, which is then painful.

Why does a Hydrocele occur ?

A hydrocele can occur in an infant in association with a hernia in the groin. This is called a congenital hydrocele. A hydrocele may appear after an injury to the testicle and sometimes as a result of infection of the testicle. A hydrocele may result from a previous operation either on the testicle or in the groin. Sometimes hydroceles develop when there is generalized swelling of the lower half of the body due to fluid retention and heart failure. Rarely, a hydrocele develops because of an underlying tumour of the testicle.

Treatment Involved for a Hydrocele

The urologist may want an ultrasound scan to confirm that the testicle is normal. Treatment depends upon the age of the patient and the degree of discomfort caused by the hydrocele. In infants when a hernia is also present, operation is normally undertaken. The hernia is repaired and the small channel through which the fluid passes into the hydrocele is closed. In adults who are suffering no discomfort, the hydrocele can be left alone. In these cases, the urologist will be quite satisfied that there is no other abnormality. Should the hydrocele become larger or uncomfortable, treatment then becomes necessary. The simplest method of treatment is by aspiration. For this procedure, a small injection of local anaesthetic is made into the skin of the scrotum. A needle is passed into the hydrocele through the anaesthetized area and the fluid is removed. Hydroceles usually recur after this treatment. Nevertheless, aspiration may be more appropriate for patients who are unfit or unwilling to have surgery. Formal operation for hydrocele should be completely curative. Operation can be performed under local or general anaesthetic usually as a day case. A small cut is made in the scrotum and the hydrocele sac is either removed or folded. The incision is repaired with dissolving (absorbable) stitches.

During Treatment for a Hydrocele

If the hydrocele fluid has been drawn off or aspirated, it is likely to re-accumulate over a 3 4 month period. Sometimes the site where the needle entered the skin of the scrotum can become infected. If this occurs, pain, redness and swelling will develop and the patient should immediately return to see his doctor.

After Treatment for a Hydrocele

Following all operations on the scrotum, swelling is very common. At least one week should be taken off work. The scrotum should be supported (an athletic support will suffice) and the patient should rest at home. Any increase in pain or swelling after the first 48 hours may indicate an underlying problem such as an infection. This is not unusual after surgery to the scrotum. Usually further operation is not required: the infected material will drain from the site of incision. Twice daily salt baths are helpful in this situation and antibiotics are often given. In the long term, if recurrence is going to occur, it will be evident at about 6 months after operation, but this is uncommon.

If a Hydrocele is Left Untreated

Most cases would remain the same, but a few hydroceles would get bigger and therefore more uncomfortable. It is always wise to get a swelling in the scrotum checked by a doctor. Even if no treatment is necessary for the hydrocele, it is both reassuring and important to know that the underlying testicle is normal.