Introduction
A hydrocele is the abnormal accumulation of fluid in the sac that surrounds the testis. Normally, the sac around the testis has a very small amount of fluid within it, to allow the testis to move freely in the scrotum – when this fluid builds up, it can create a amass in the scrotum that can cause a dragging sensation and be very uncomfortable to walk, sit and engage in intercourse.
Indications
A hydrocelectomy is performed when a patient has a large hydrocele that causes them significant discomfort.
Preoperative Instructions
All patients are given full instructions on how to prepare for the procedure well ahead of the day of surgery. In most cases the following preparation is required:
- Inform the surgical team of what medications you are currently taking and follow any guidelines given by the team, especially regarding blood thinning medication.
- If any symptoms of illness occur before the procedure (e.g. cold or fever) inform the surgical team.
- Bring (or wear) reasonably close-fitting underwear to give support to the scrotum after the procedure.
Procedure
The scrotum is prepped with an antibiotic solution. An incision is made and dissection down to the sac or fluid (hydrocele) around the testis is performed. The sac is then opened and the fluid drained. Parts of the sac are then excised and sutured back together to prevent another hydrocele from occurring. The wound is then closed, and a dressing is placed over the suture line.
Postoperative Instructions
After a hydrocele repair, the patient is advised to wear supportive underwear, and not partake in any contact sport for a period of two weeks. The patient should also not engage in heavy lifting or straining for a period of 6 weeks.
Risks
The risks of a hydrocele repair include, but are not limited to the following:
- Scrotal haematoma.
- Infection.
- Recurrence of the hydrocele.
Treatment Alternatives
Alternative treatments for a hydrocele include aspiration of the fluid with a needle with or without injection of a sclerosing agent, however this treatment is associated with a high recurrence rate of the hydrocele.