A hydrocelectomy is a surgical procedure performed to remove a hydrocele, a fluid-filled sac that forms around a testicle. This common procedure is considered safe and effectively addresses the swelling and discomfort caused by a hydrocele. It aims to prevent fluid reaccumulation, restoring comfort and normal appearance to the affected area.
Understanding a Hydrocele
A hydrocele is a collection of fluid in the scrotum, the pouch of skin holding the testicles. This swelling occurs when fluid gathers in the thin sac surrounding a testicle, known as the tunica vaginalis. While often painless, a hydrocele can cause discomfort, a feeling of heaviness, or cosmetic concerns, especially if it grows significantly.
Hydroceles are particularly common in newborn males, with approximately 10% having one at birth; they often resolve on their own by age one or two. In adults, hydroceles can develop for various reasons, including injury, infection, or inflammation within the scrotum. Sometimes, the cause remains unknown. Surgical intervention, a hydrocelectomy, is typically considered when the hydrocele causes significant size, discomfort, interferes with daily activities, or for cosmetic reasons. If the hydrocele is large enough to cause pain or physical issues, removal is often recommended.
The Hydrocelectomy Procedure
The hydrocelectomy procedure typically begins with the administration of anesthesia to ensure patient comfort. This can include general anesthesia, which induces a sleep-like state, or spinal anesthesia. In some cases, local anesthesia may also be used. Before surgery, patients are advised not to eat or drink anything after midnight on the day before the procedure.
The surgeon makes a small incision, in the scrotum or sometimes the groin, depending on the type of hydrocele and the surgeon’s approach. For instance, a scrotal incision is common for a hydrocele testis, while an inguinal approach might be used for a communicating hydrocele or if a hernia is present. Once the incision is made, the hydrocele sac is exposed and opened. The accumulated fluid is then drained.
After drainage, the hydrocele sac is either partially removed (resected) or everted (turned inside out) and stitched to prevent fluid from reaccumulating. This eversion technique helps prevent recurrence. The testicle and surrounding structures are inspected to ensure they appear normal.
In certain situations, particularly after extensive dissection or if a large hydrocele was present, a small drainage tube might be placed temporarily to minimize swelling. Finally, the incision is closed with stitches, which are absorbable. The entire procedure typically lasts less than an hour, and most patients can return home the same day.
Recovery and Post-Operative Care
Following a hydrocelectomy, patients can expect some discomfort, swelling, and bruising in the scrotal area. These symptoms improve within two to three weeks. Pain can be managed with over-the-counter pain relievers such as acetaminophen or ibuprofen, or prescription pain medication if necessary. Applying ice packs to the scrotum for the first 24 to 48 hours can help reduce swelling and pain.
Patients are advised to rest for the first 24 to 48 hours after surgery, avoiding strenuous activities and heavy lifting. Activity restrictions, such as avoiding lifting anything over 15 to 20 pounds, strenuous exercise, and sexual activity, are recommended for two to four weeks to allow proper healing and reduce complications. Wearing a scrotal support, such as a jockstrap or snug briefs, day and night for about one week is recommended to provide support and minimize swelling.
Wound care involves keeping the incision site clean and dry. Showering is permitted 24 to 48 hours after surgery, but baths, swimming, or soaking the incision should be avoided for a week or until the area is fully healed. Follow-up appointments are scheduled within a few days to a few weeks after surgery to check the incision and remove any drains or non-dissolvable stitches. Patients should contact their healthcare provider if they experience signs of complications like fever, excessive swelling, severe pain, or increased redness or discharge from the incision site. Minor swelling may persist for several months, but it should continue to improve over time.