Hydrocelectomy is a kind of surgery used to remove fluid-filled sacs called hydroceles. These form in the scrotum, the muscular pouch of skin that holds and protects the testicles.
A hydrocele forms when fluid from the abdomen flows into the scrotum. A hydrocele causes swelling but is usually not painful. Some people describe it as feeling a little like a water balloon.
Roughly 1 out of every 10 boys is born with a hydrocele, according to the Urology Care Foundation. Studies indicate that the condition resolves itself by the time the majority of these boys are 2 years old.
Fast facts on hydroceles
|Here are some key points about hydroceles. More detail and supporting information is in the main article.
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
Hydroceles in children
For infants with congenital hydroceles, the condition develops between the 28th and 32ndTrusted Source weeks of pregnancy, when a muscle in the scrotum opens to let the testes drop.
In some cases, the muscle stays open longer than is needed, doesn’t close properly, or opens again, allowing fluid from the belly to flow into the scrotum and form a hydrocele.
Premature birth, cystic fibrosis, and other conditions may increase the likelihood Trusted Source of problems with closure of this muscle.
Hydroceles in adults
In adults, hydroceles affect about 1 percent of men over 40 years. Radiation treatment for prostate cancer may increase the risk of developing a hydrocele.
When non-communicating hydroceles develop in adult men, the cause is usually unknown. A hydrocele itself does not cause pain, but men may experience discomfort due to the size and weight of the swollen scrotum.
Even in adults, the condition may disappear on its own in a few months, but if it does not, medical attention is needed and a person should consider having a hydrocelectomy.
What is the procedure for hydrocelectomy?
The procedure takes place under a general anesthetic. If an infant has a hydrocele that does not go away on its own, surgeons will wait until the child is at least 1 to 2 years old before operating.
The steps involved with a hydrocelectomy depend on whether the hydrocele is communicating or non-communicating:
- Non-communicating hydrocele: Surgeons make an incision in the scrotum, remove the sac, drain the fluid, and close the incision.
- Communicating hydrocele: Treatment is slightly more complicated; doctors make an incision through the groin so that they can treat a hernia, if present, at the same time as removing the hydroceles. Even if there is no hernia, doctors take this approach to prevent a hernia from developing in the future.
Some surgeons will conduct a hydrocelectomy through laparoscopic (keyhole) surgery, inserting a tube equipped with a camera through the abdomen.
In some cases, individuals and their doctors opt for draining the hydroceles, which can be effective. However, this procedure carries a greater risk of the hydroceles returning.
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. An incision is made in the scrotum or lower abdomen to remove the hydrocele. If a hydrocele is found during surgery to repair an inguinal hernia, the surgeon might remove the hydrocele even if it’s causing no discomfort.