Hydrocele is a problem that affects infants and adults

Men typically don’t pay much attention to health issues unless they start causing discomfort. One thing that can make a man concerned is any noticeable change in the size or shape of his testicles. Sometimes, men may notice slight swelling or fluid buildup around the testicles, which is usually not dangerous. However, when the swelling becomes more pronounced—reaching the size of an orange—at  we recognize this as a condition called hydrocele.So, what causes it? Is it dangerous? And how can it be treated? That’s exactly what we’lL explore in detail in this article.

What is a Hydrocele?
A hydrocele is a condition that affects males, but it can also appear in newborns and children. Normally, there is a small amount of fluid (about 0.5 - 1 ml) between the testicle and the surrounding membranes to help lubricate the testicle. However, in the case of a hydrocele, this fluid increases and can reach about 100 - 200 ml, or even more in some cases.

Does a Hydrocele Cause Pain in the Scrotum?
As mentioned earlier, a hydrocele itself does not cause pain. However, if someone experiences sudden and severe pain in the scrotum, it could be due to testicular torsion, which may occur after an injury or surgery. In such cases, immediate medical attention is required, as testicular torsion cuts off blood supply to the testicle and may lead to infertility if not treated promptly. Additionally, if there is swelling in the scrotum accompanied by pain, it is advisable to get an ultrasound scan to rule out testicular cancer or other potential issues.

Success Rate of Hydrocele Surgery
The success rate of hydrocele surgery is very high, reaching approximately 95 - 99%. The procedure itself is simple, does not take much time, and aims to remove the accumulated fluid or fix the underlying cause of the fluid buildup. In some cases, fluid may reaccumulate after the surgery, but this is usually minimal and resolves over time.

Does a Hydrocele Cause Infertility?
It is important to differentiate between a varicocele and a hydrocele. A varicocele affects blood cooling in the arteries supplying the testicle, and if this cooling process is disrupted, testicular temperature may rise, impacting sperm production and potentially causing infertility. On the other hand, a hydrocele typically does not affect fertility unless it is caused by an infection or a tumor. In such cases, it could impact sperm production and reduce fertility.

When Can Intercourse Resume After Hydrocele Surgery?
After hydrocele surgery, patients need to wait before resuming sexual activity. Generally, doctors recommend waiting 2 to 4 weeks until the wound heals completely and any swelling or discomfort subsides. It is always best to consult your doctor before resuming intercourse to ensure there are no complications.

The Relationship Between a Varicocele and a Hydrocele
A hydrocele can sometimes develop after a varicocele, especially if the varicocele was not fully treated or if the surgeon did not remove associated lymphatic tissues. Additionally, insufficient rest after varicocele surgery may lead to fluid accumulation around the testicle, causing swelling and enlargement. If the fluid buildup is minor, it often resolves on its own. However, if the swelling is significant, draining the fluid may be necessary.

Can a Hydrocele Recur After Treatment?
Hydrocele treatment is usually permanent, but in some cases, it can recur. In men over 40 years old, hydroceles may be linked to infections, tumors, injuries, or fluid retention causing body-wide swelling. Treatment depends on the underlying cause.

If the hydrocele is drained with a needle, there is a chance it might return. However, injecting a special solution during the procedure can help prevent fluid from accumulating again.

If a hydrocele returns after surgery or if swelling and pain develop in the scrotum, it is essential to consult a doctor immediately for proper evaluation and treatment.

1) How Long Should I Stay in the Hospital After Surgery?
In most cases, the patient can be discharged on the same day of the surgery, either in the afternoon or the next morning. If a drainage tube was used during the procedure, it is usually removed before discharge.

2) When Can I Start Walking After Surgery?
Walking is possible a few hours after the surgery, but it is best to have assistance. To stand up safely, first sit on the edge of the bed, lower your legs to the ground, then stand up slowly with the help of someone.

3) What Can I Eat After Hydrocele Surgery?
About 8 hours after surgery, you can start drinking fluids. However, if you had general anesthesia, you should wait until the next day before eating or drinking.

4) When Can I Return to Work After Surgery?
Recovery time depends on the nature of your job. Most people return to work after one week, especially if the job does not require heavy physical effort.

5) When Should I Change the Dressing After Surgery?
The dressing applied after surgery should be removed after two days. If there are no discharges or fluids coming from the wound, there is no need to apply a new dressing.

6) When Can I Take a Shower After Surgery?
You can shower 48 hours after surgery, but make sure that the drainage tube (if used) has been removed and there are no discharges from the wound.

7) When Are the Stitches Removed After Hydrocele Surgery?
If absorbable stitches were used, they will dissolve on their own over time. However, if non-absorbable stitches were used, they are usually removed after 7 to 10 days, depending on your doctor's instructions.

 

8) Can a Hydrocele Return After Surgery?
In rare cases, a hydrocele can return after surgery due to a new accumulation of fluid around the testicle. However, this is uncommon.

9) What Medications Should I Take After Surgery?
Depending on the level of pain or any symptoms after surgery, your doctor will likely prescribe antibiotics and pain relievers to reduce discomfort and prevent infections.

10) Does a Hydrocele Affect Reproductive Health?
A hydrocele does not negatively impact fertility or sexual function. However, in some cases, it may cause a feeling of heaviness or mild pain. Additionally, the swollen appearance of the testicles may cause psychological discomfort, which is why many people opt for surgery to remove the swelling.

The cost of hydrocele surgery varies between children and adults, depending on factors such as the hospital, type of anesthesia, and the surgeon’s expertise.

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Types of Hydroceles and Their Causes Based on Age Group

Hydroceles are classified into two types:

1. Congenital Hydrocele (Occurs in Infants)
2. Adult-Onset Hydrocele

Congenital Hydrocele

During fetal development, the testicles are initially located in the abdomen. Around the 14th week of pregnancy, they begin moving down into the scrotum. During this descent, a small part of the abdominal lining is pulled along with the testicles. Normally, this passage closes completely after birth, leaving only a thin thread-like structure.

If this sac does not close after birth, abdominal fluid can pass through the opening and accumulate around the testicle, leading to what is known as congenital hydrocele.

This condition occurs in approximately 6% of newborn male infants. Most congenital hydroceles are harmless and resolve on their own, but in rare cases, they may be caused by infections, circulatory issues, or even tumors.

Adult-Onset Hydrocele

Hydrocele in adult men is extremely rare, affecting approximately 1 in 100,000 men, and it typically occurs after the age of 40. Possible causes include:

• Trauma or injury to the scrotum
• Infections in the testicle or epididymis (the tube that carries sperm)
• Testicular tumors
• Previous surgeries, such as varicocele surgery
• Radiation therapy

Is a Hydrocele Harmful to the Testicles?

For infants, even though fluid around the testicle may seem concerning to parents, hydroceles are rarely serious. They do not usually affect future fertility unless they become very large. Most hydroceles are painless and do not interfere with testicular function, but monitoring is essential to rule out any underlying conditions, such as:

• Inguinal Hernia: Some infants with a hydrocele may also have an inguinal hernia, which may require medical intervention.
• Infections or Inflammation: Long-term fluid accumulation can increase the risk of infections in the testicle.
• Pressure on the Testicle: In very rare cases, if the fluid buildup is excessive, it may put pressure on the testicle, affecting blood flow or normal growth.

How to Know If You Have a Hydrocele?

In most cases, a hydrocele does not cause pain. The only noticeable symptom is swelling in the scrotum, which may appear slightly larger in the morning. If the hydrocele is small, it may feel like a water-filled balloon inside the scrotum.

In adults, if the swelling becomes too large, it can make walking or sexual activity uncomfortable due to the feeling of heaviness.

In some cases, a hydrocele may be associated with an inguinal hernia, which occurs when a part of the intestine moves into the scrotum due to weakness in the abdominal wall. This condition requires medical attention for proper treatment.

Symptoms of a Hydrocele

1. Scrotal Swelling

• Usually painless.
• May appear on one or both sides of the scrotum.

2. Transillumination (Transparency Test)

• A doctor may shine a small light through the scrotum.
• If the light passes easily, it means the swelling is caused by clear fluid (a hydrocele), rather than a solid mass or tumor.

3. Changes in Swelling Size During the Day

• In communicating hydroceles, the swelling increases throughout the day as more fluid accumulates in the scrotum.
• In the morning, the swelling decreases as the fluid drains back into the abdominal cavity during sleep.

4. No Additional Symptoms

• Most hydrocele cases do not cause pain, fever, or discomfort.
• However, if the hydrocele is due to an infection or inflammation, symptoms may include pain, redness, and warmth in the scrotum.

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When Should You See a Doctor?

In most cases, hydroceles in newborns disappear on their own within the first year and do not require treatment. However, you should see a doctor in the following situations:

✔ If the hydrocele persists beyond the first year

• If the swelling is still present after the child turns one year old, a doctor should evaluate whether medical intervention is needed.

✔ If the swelling is large and uncomfortable

• If the child experiences discomfort, has difficulty moving, or if the swelling is excessively large, medical consultation is necessary.

✔ If pain, redness, or warmth appears

• A painful, red, or warm hydrocele could indicate an infection or inflammation, requiring immediate medical attention.

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How Is a Hydrocele Diagnosed?

1. Transillumination Test

• The doctor shines a light behind the scrotum.
• If the light passes through, it confirms fluid accumulation (hydrocele).
• If the light does not pass through, the swelling might be caused by a tumor or solid mass, requiring further tests.

2. Ultrasound (Sonography)

• Ultrasound helps determine the amount of fluid and rules out other conditions like inguinal hernia or testicular tumors.

3. Additional Examinations for More Serious Cases

✔ Physical examination to check for pain and tenderness in the scrotum.
✔ Abdominal and scrotal pressure test to rule out an inguinal hernia.
✔ Blood and urine tests if an infection or inflammation is suspected.
✔ Doppler Ultrasound to rule out testicular torsion (twisting of the testicle).
✔ Tumor marker tests if testicular cancer is suspected.

Preparation for Hydrocele Surgery – Step by Step Guide

Proper preparation ensures the safety and success of the surgery while minimizing potential complications. Here’s everything you need to know before the procedure:

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1. Urologist Consultation

✔ Schedule an appointment with a urology specialist to discuss symptoms and medical history.
✔ The doctor will assess your condition and determine whether surgery is necessary.
✔ Additional tests such as ultrasound or blood tests may be required.

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2. Pre-Surgery Medical Tests

 Ultrasound Scan → To determine the size and location of the hydrocele.
Blood and Urine Tests → To rule out infections or underlying health issues that might interfere with surgery.
❤️ Electrocardiogram (ECG) → Required for older patients or those with chronic conditions to ensure heart health before anesthesia.

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3. Medication Discussion with the Doctor

 If you're taking blood thinners (such as Aspirin or Warfarin), inform your doctor. You may need to stop them before surgery to reduce bleeding risks.
 If you're on chronic medications (for high blood pressure, diabetes, heart disease, etc.), discuss adjustments with your doctor.
Avoid herbal supplements and vitamins before surgery, as they may interfere with anesthesia.

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4. Fasting Instructions Before Surgery

 No food or drink for at least 8 hours before surgery, as per your doctor’s instructions.
☕ Avoid caffeine and carbonated drinks before the procedure.

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5. Surgery Day Preparations

 Wear loose and comfortable clothing (preferably wide-legged pants to prevent pressure on the scrotum after surgery).
Remove jewelry and accessories, as they must be taken off before surgery.
Take a warm shower with medical soap before the procedure and follow any shaving or cleaning instructions given by your doctor.

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6. Smoking and Alcohol Restrictions

 If you smoke, try to reduce or quit before surgery, as smoking slows down wound healing.
Avoid alcohol, as it can interfere with anesthesia and recovery.

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7. Arranging Transportation

 After surgery, you will not be able to drive due to the effects of anesthesia. Arrange for someone to drive you home safely.

Post-Surgery Care Preparation

✔ Arrange for a family member or friend to assist you at home for the first two days, as you may need help with movement and meals.
✔ Set up a comfortable resting area with an extra pillow to support the scrotal area.

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Follow Medical Team Instructions

✔ Adhere strictly to preparation, anesthesia, and surgery instructions given by the doctor and hospital.
✔ If you have any concerns, ask your doctor to feel reassured before the procedure.

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Summary of Pre-Surgery Preparations

✔ Medical tests and lab work
✔ Stopping certain medications (if necessary)
✔ Fasting before surgery
✔ Wearing comfortable clothing and maintaining hygiene
✔ Reducing smoking and alcohol consumption
✔ Arranging transportation and home assistance

Following these steps ensures a smooth surgical experience and faster recovery!

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Hydrocele Treatment Options

If you notice scrotal swelling due to a hydrocele, early treatment can prevent complications and further enlargement. Surgery is the most effective solution, but other options exist.

1. Surgery (Hydrocelectomy)

✔ The most common and effective treatment for hydrocele.
✔ The surgeon drains the fluid and removes the membrane producing excess fluid.
✔ Performed under local or general anesthesia and lasts 30-60 minutes.
✔ A drain tube may be placed for a few days in severe swelling cases.

Potential Side Effects of Surgery:

 Bleeding or hematoma formation
Infection risk
Nerve damage
Prolonged scrotal swelling

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2. Aspiration & Sclerotherapy (Non-Surgical Option)

✔ A needle is inserted to drain the accumulated fluid.
✔ A medication is injected to prevent fluid from reaccumulating.
✔ Suitable for patients unable to undergo surgery due to medical conditions.

Potential Side Effects:

 Temporary pain in the scrotum
Infection risk
Hydrocele recurrence

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Post-Hydrocele Surgery Recovery

 When does the pain subside? Within a week after surgery.
 When does the swelling fully disappear? 2 to 3 months after the procedure.
 When can normal activities be resumed? Within 1 to 2 weeks.

Tips for a Faster Recovery:

✔ Apply ice packs within the first 24 hours to reduce swelling.
✔ Take doctor-prescribed pain relievers for comfort.
✔ Avoid heavy lifting, strenuous activities, and sports.
✔ Refrain from long sitting hours and cycling for at least 3 weeks.

Recovery After Hydrocele Surgery

Recovering after surgery is a crucial phase to ensure proper healing and minimize complications. Here’s what to expect after the procedure and how to take care of yourself during this period:

First 24 Hours After Surgery

• Medical Monitoring: After the surgery, you will spend some time in the recovery room for observation.
• Going Home: You can usually be discharged the same day, but someone should accompany you as you may feel dizzy due to anesthesia.
• Pain Management: Mild pain or discomfort in the scrotal area is normal, and your doctor will prescribe pain relievers.
• Normal Swelling: Some swelling is expected. You can reduce it by applying cold compresses to the scrotum for 15-20 minutes every hour.

First Week After Surgery

• Complete Rest: Avoid strenuous activities like lifting heavy objects or walking long distances.
• Scrotal Support: Use a pillow or special support while sitting or sleeping to reduce swelling.
• Wound Care: Keep the incision clean and dry, and follow your doctor’s instructions on changing bandages.
• Supportive Underwear: Wearing snug-fitting underwear can help reduce pain and swelling.
• Medication Adherence: Take prescribed painkillers and antibiotics regularly to prevent infections.

Contact Your Doctor Immediately If You Notice:

• Severe pain that doesn’t improve with painkillers.
• Excessive redness or significant swelling.
• Pus discharge or bleeding from the wound.
• Fever or high temperature.

Week Two to Four After Surgery

• Stitches and Bandage Removal: If stitches are non-absorbable, your doctor will remove them during a follow-up appointment.
• Gradual Return to Daily Activities: You may return to work if it doesn’t involve strenuous physical effort.
• Avoid Sexual Activity: It is advised to refrain from sexual intercourse for 3-4 weeks to ensure full recovery.
• Light Walking: Helps improve blood circulation and prevent blood clots.

Full Recovery (After 2-3 Months)

✔ Swelling typically subsides completely within 8-12 weeks.
✔ You can resume sports and strenuous activities with your doctor’s approval.
✔ If you experience recurring pain or swelling, consult your doctor.

Lifestyle Adjustments After Hydrocele Surgery

After undergoing hydrocele surgery, certain lifestyle modifications can significantly contribute to a smooth recovery and prevent complications. Here are key tips for a successful healing process:

1. Follow Post-Surgery Instructions

• Adhere to all medical advice regarding wound care, medication, and activity restrictions.
• Attend all follow-up appointments to ensure proper healing.

2. Proper Nutrition and Hydration

• Maintain a balanced diet rich in proteins, vitamins, and minerals to aid wound healing.
• Drink plenty of water to keep your body hydrated and speed up recovery.
• Avoid fatty or processed foods that may cause constipation, as straining during bowel movements can be uncomfortable.

3. Medication Compliance

• Take prescribed painkillers and antibiotics as directed to manage pain and prevent infections.
• If you experience unusual side effects, consult your doctor immediately.

4. Engage in Physical Activity with Caution

• Light walking after surgery can boost circulation and reduce the risk of blood clots.
• Avoid heavy lifting or intense physical activities for at least 3-4 weeks.
• Do not sit or stand for prolonged periods to prevent swelling and discomfort.

5. Avoid Pressure on the Scrotal Area

• Wear supportive underwear or an athletic supporter to provide comfort and reduce swelling.
• When sitting or sleeping, use a pillow to elevate the scrotum and improve circulation.
• Move cautiously, especially when sitting or standing, to avoid straining the surgical site.

6. Resuming Sexual Activity

• Consult your doctor before resuming sexual activity, which is typically recommended after 3-4 weeks.
• Avoid any activity that may cause discomfort or pressure on the scrotum until fully healed.

7. Stay in Touch with Your Doctor

• Contact your doctor if you experience severe pain, unusual redness, abnormal swelling, or discharge from the wound.
• Fever or persistent fatigue may indicate an infection, so seek medical advice immediately.

Ways to Prevent Hydrocele

Although hydrocele may not always be preventable, certain steps can help reduce the risk, especially in adults. Here are the key prevention methods:

1. Protect the Scrotum from Injuries

• Wear an athletic cup (scrotal support) during contact sports such as football, boxing, and cycling.
• Be cautious when riding bicycles or motorcycles, as vibrations and impacts can cause scrotal injuries.
• Avoid activities that may lead to direct trauma to the testicles.

2. Regular Medical Check-ups

• Undergo periodic testicular examinations by a doctor, especially if you experience unusual swelling or heaviness in the scrotum.
• Perform self-examinations regularly to detect any early changes, such as swelling or abnormal lumps.

3. Maintain a Healthy Lifestyle

• Follow a nutritious diet rich in vitamins and minerals to support reproductive health.
• Avoid harmful habits like smoking and alcohol, as they can affect blood circulation and testicular health.
• Stay hydrated by drinking enough water to maintain healthy tissues and reduce the risk of infections.

4. Prevent Infections

• Treat urinary or reproductive infections promptly, as some infections can lead to fluid accumulation around the testicle.
• Maintain good personal hygiene to prevent infections of the testicles and epididymis.
• Avoid unsafe sexual behaviors that may cause infections linked to hydrocele development.

5. Avoid Excessive Pressure or Strain

• Lift heavy objects properly to prevent inguinal hernia, which can contribute to hydrocele.
• If you experience pain or swelling in the scrotum after exercise or strenuous work, consult a doctor immediately.

The specialist who treats hydrocele is a urologist, as they handle issues related to the urinary and reproductive systems in men. In some cases, a general surgeon may also be involved, especially if surgical intervention is required.