What is a Hydrocele?
A hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle. Hydrocele is common in newborns and usually disappears without treatment by age 1. Older boys and adult men can develop a hydrocele due to inflammation or injury within the scrotum.
A hydrocele usually isn’t painful or harmful and might not need any treatment. But if you have scrotal swelling, see your doctor to rule out other causes.
Hydrocele surgery in Iran
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Before Hydrocele Treatment
Symptoms
Usually, the only indication of a hydrocele is a painless swelling of one or both testicles.
Adult men with a hydrocele might experience discomfort from the heaviness of a swollen scrotum. Pain generally increases with the size of the inflammation. Sometimes, the swollen area might be smaller in the morning and larger later in the day.
When to see a doctor
See your doctor if you or your child experiences scrotal swelling. It’s important to rule out other causes of the swelling that might require treatment. For example, a hydrocele might be associated with a weak point in the abdominal wall that allows a loop of intestine to extend into the scrotum (inguinal hernia).
A baby’s hydrocele typically disappears on its own. But if your baby’s hydrocele doesn’t disappear after a year or if it enlarges, ask your child’s doctor to examine the hydrocele again.
Get immediate medical treatment if you or your child develops sudden, severe scrotal pain or swelling, especially within several hours of an injury to the scrotum. These signs and symptoms can occur with a number of conditions, including blocked blood flow in a twisted testicle (testicular torsion). Testicular torsion must be treated within hours of the beginning of signs and symptoms to save the testicle.
Causes
. Baby boys
A hydrocele can develop before birth. Normally, the testicles descend from the developing baby’s abdominal cavity into the scrotum. A sac accompanies each testicle, allowing fluid to surround the testicles. Usually, each sac closes and the fluid is absorbed.
Sometimes, the fluid remains after the sac closes (noncommunicating hydrocele). The fluid is usually absorbed gradually within the first year of life. But occasionally, the sac remains open (communicating hydrocele). The sac can change size or if the scrotal sac is compressed, fluid can flow back into the abdomen. Communicating hydroceles are often associated with inguinal hernia.
. Older males
A hydrocele can develop as a result of injury or inflammation within the scrotum. Inflammation might be caused by an infection in the testicle or in the small, coiled tube at the back of each testicle (epididymitis).
Risk factors
Most hydroceles are present at birth. At least 5 percent of newborn boys have a hydrocele. Babies who are born prematurely have a higher risk of having a hydrocele.
Risk factors for developing a hydrocele later in life include:
. Injury or inflammation to the scrotum
. Infection, including a sexually transmitted infection (STI)
Complications
A hydrocele typically isn’t dangerous and usually doesn’t affect fertility. But a hydrocele might be associated with an underlying testicular condition that can cause serious complications, including:
. Infection or tumor. Either might reduce sperm production or function.
. Inguinal hernia. The loop of intestine trapped in the abdominal wall can lead to life-threatening complications.
Diagnosis
Your doctor will start with a physical exam. It’s likely to include:
. Checking for tenderness in an enlarged scrotum.
. Applying pressure to the abdomen and scrotum to check for inguinal hernia.
. Shining a light through the scrotum (transillumination). If you or your child has a hydrocele, transillumination will show clear fluid surrounding the testicle.
After that, your doctor might recommend:
. Blood and urine tests to help determine if you or your child has an infection, such as epididymitis
. Ultrasound to help rule out hernia, testicular tumor or other causes of scrotal swelling
How common is a hydrocele?
About 10% of newborn male infants have a hydrocele, which often clears up without any particular treatment within the first year of life. Hydroceles occur in only about 1% of adult men, and will often disappear on their own.
Can a hydrocele be prevented?
There is nothing you can do to prevent your baby from getting a hydrocele. For adolescent and adult men, the best protection against a hydrocele is to keep the testicles and scrotum free of injury. For example, if taking part in contact sports, use an athletic cup.
Although hydroceles are usually not a major health issue, you should tell your healthcare provider about any abnormality or swelling in the scrotum. Another disease or condition may be causing or mimicking the abnormality.
During Hydrocele Treatment
What are the types of hydrocele?
There are two: communicating hydrocele and non-communicating hydrocele.
. Communicating hydrocele: This is a type of hydrocele that has contact (communication) with the fluids of the abdominal cavity. A communicating hydrocele is caused by the failure of the processus vaginalis (the thin membrane that extends through the inguinal canal and extends into the scrotum). If this membrane remains open, there is a potential for both a hernia and a hydrocele to develop. The child’s scrotum will appear swollen or large and may change in size throughout the day.
. Non-communicating hydrocele: In this type, the inguinal canal did close, but there is still extra fluid around the testicle in the scrotum. This condition might be present at birth or might develop years later for no obvious reason. A non-communicating hydrocele usually remains the same size or has very slow growth.
Treatment
In baby boys, a hydrocele sometimes disappears on its own. But for males of any age, it’s important for a doctor to evaluate a hydrocele because it can be associated with an underlying testicular condition.
A hydrocele that doesn’t disappear on its own might need to be surgically removed, typically as an outpatient procedure. The surgery to remove a hydrocele (hydrocelectomy) can be done under general or regional anesthesia.
What happens during a hydrocelectomy?
In infants, the surgery focuses on closing the processus vaginalis, which should have closed on its own before birth. In adult men, surgery may be done when the swelling from the hydrocele is painful, embarrassing, or when it grows to a size that threatens the function of the rest of the genital tissues.
Surgery is usually performed under general anesthesia (the patient is given drugs to put him to sleep). After the patient is asleep surgery includes these steps:
. The surgeon makes a small cut in the scrotum or groin close to the scrotum and drains out the fluid via suction.
. The surgeon also closes the communication to the canal between the abdominal cavity and the scrotum.
. The hydrocele sac is then removed and the incision is closed up.
. If the patient also has a hernia, the surgeon will probably repair that as well.
After Hydrocele Treatment
What happens after hydrocelectomy?
This surgery is a relatively minor one and most patients return home the same day. It is recommended that patients apply ice packs to the area for 24 hours following the procedure and they should take pain relievers such as ibuprofen. For patients who need more extensive surgery, the surgeon may prescribe a stronger pain reliever.
Some patients will have a small amount of bruising and swelling but that is normal. As with any surgery, there is a small chance of the surgical area becoming infected. If there is fever, pain, or heat or a lot of swelling in the treated area, you should call the doctor right away. A small amount of blood may seep out onto the bandages but a heavy amount of blood should be reported to the doctor right away also.
Some patients will go home with a small drain coming out of the surgical site to help remove any fluids from the tissue. The doctor usually will remove it in a day or two.
Will I have any limitations after hydrocelectomy?
Most patients can resume normal activities in about 2 days, unless their surgery was extensive. For infants, parents should take care to keep the area as clean and dry as possible. Adult men generally should wait at least 2 weeks to resume strenuous work or sexual activity. Showering is generally OK but bathing should be avoided until the area has healed.
Sources:
. https://www.mayoclinic.org/diseases-conditions/hydrocele/symptoms-causes/syc-20363969
. https://my.clevelandclinic.org/health/diseases/16294-hydrocele
. https://my.clevelandclinic.org/health/treatments/16232-hydrocelectomy
How long does it take to recover from a Hydrocelectomy?: This usually gets better in 2 to 3 weeks. You will probably be able to go back to work or school 4 to 7 days after surgery. But you will need to avoid strenuous exercise or heavy lifting for 2 to 4 weeks. This care sheet gives you a general idea about how long it will take for you to recover.
What causes a hydrocele in adults?: The scrotum is the sac of skin that holds the testicles once they descend. … This can cause fluid to move from the abdomen into the scrotum. Hydroceles can also be caused by inflammation or injury in the scrotum or along the channel. The inflammation may be caused by an infection (epididymitis) or another condition.
Can hydrocele be cured without surgery?: Hydrocele Treatment. Most hydroceles resolve without medical treatment. However, if the condition causes discomfort or becomes very large, treatment may be necessary. … Aspiration is not the most common treatment for hydroceles, but it may be performed when surgery is too risky.
Is hydrocele an emergency?: Emergency Department Care. Differentiating between a hydrocele and an acute scrotum (eg, testicular torsion, strangulated hernia) is important. As many as 50% of acute scrotum cases are initially misdiagnosed. Transillumination is not diagnostic and cannot rule out an acute scrotum.
Can a hydrocele come back after surgery?: But the hydrocele may come back within months, requiring another round of aspiration and sclerotherapy. Surgery is the most long-lasting repair, with a much lower hydrocele recurrence rate.
Is hydrocele surgery dangerous?: Hydrocelectomy is usually successful, and major complications are very rare. Another hydrocele can form after surgery, requiring additional treatment, but this isn’t common. Contact your doctor promptly if you start having swelling and pain in your scrotum again.
What should I do after hydrocele surgery?: In addition to pain relievers, using an ice pack on the affected area can also help. Some individuals may need to use special bandages or a drainage tube during their recovery process. For a few weeks after surgery, swelling may continue.
Is hydrocele curable without surgery?: Hydrocele Treatment. Most hydroceles resolve without medical treatment. However, if the condition causes discomfort or becomes very large, treatment may be necessary. … Aspiration is not the most common treatment for hydroceles, but it may be performed when surgery is too risky.
Is surgery necessary for hydrocele?: Surgery to repair a hydrocele is often done at an outpatient clinic. General anesthesia is used so you will be asleep and pain-free during the procedure.
Is hydrocele surgery painful?: After your surgery, you may feel more tired than usual and have some mild groin pain for several days. Your groin and scrotum may be swollen or bruised. This usually gets better in 2 to 3 weeks. You will probably be able to go back to work or school 4 to 7 days after surgery.
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