All About Hydrocele

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Hydrocele : Treatment, Causes & Symptoms
A hydrocele is very common in newborn males and usually disappears after a year. Most commonly, fluid travels from the abdomen and collects around one or both testicles.

Hydrocele surgery or hydrocelectomy is a minor surgery performed to remove or repair the hydrocele from the scrotum. This condition can be seen in both infants and adults.

This surgery is needed when the patient shows symptoms and the most common symptom is an enlargement of the testicles. Before this, some blood tests and radiological tests are done.

It does not take much time and the patient can be admitted to the hospital in the morning and go home by evening. Recovery is also quick, but it is important to take care after surgery to avoid any complications.

What Is Hydrocele Surgery?

Around the testicles is a fluid-filled sac called a hydrocele. Hydrocele is a sensitive part of the body and increasing its size is a matter of concern.

Hydroceles usually heal on their own, but in some cases, swelling can develop with severe symptoms. Then it has to be treated with surgery. The procedure to repair or remove a hydrocele is called hydrocelectomy or hydrocele surgery.

Depending on the age of the patient, this procedure can be done in two ways:

  • Hydrocele surgery in infants
  • Hydrocele surgery in adults

When Is Hydrocele Surgery Needed?

Hydroceles usually do not show symptoms. However, it may be needed in the following situations –

  • Infants over one year of age – Congenital hydroceles resolve on their own without any treatment by the age of one year. However, if the swelling persists even after this or the hydrocele is increasing in size then it needs to be removed.
  • If the following symptoms are seen in adults, surgery has to be done –
  • The odd appearance of hydrocele due to abnormal size of swelling
  • A sudden increase in swelling
  • Pain in the hydrocele and pain when touched, can be a sign of “testicular torsion” (stopping the blood supply to the testicle). This is a medical emergency situation.
  • Infection in inflammation including fever, pain on the touch, and warmth around the swelling (due to accumulation of pus).
  • Cysts in the testicles. Pus discharge or bleeding due to infection or trauma to the sexual organ.

When Should Not Do Hydrocele Surgery?

There are very few risks of this surgery. However, if you have a pre-existing condition such as diabetes or heart disease, there may be an increased risk of infections and complications associated with anesthesia after surgery. Therefore, it is important to control these conditions before surgery.

Premature delivery can occur due to hydrocele in the baby. Before opting for this surgery, one should know about the risks of surgery by checking for other conditions in the child.

What Is The Preparation Done Before Surgery?

Depending on the age of the patient, this surgery is performed by a general surgeon or a pediatric surgeon. The surgeon will explain the risks associated with the surgery to the patient or his or her parents.

The patient is asked about symptoms, birth details in case of a baby, any pre-existing diseases, and what medicines they are taking. Parents give all this information to the baby.

Physical examination and other tests are done to detect hydrocele. The following tests are done before surgery:

  • Routine blood test
  • Chest X-ray
  • ECG
  • Abdominal ultrasound and pelvic ultrasound. This reveals the following things:
  1. To find out the size of the hydrocele
  2. What kind of fluid is inside the hydrocele
  3. To detect any related abnormality
  4. To see if something else is present inside the testes
  5. to reach and see the other testicle

For this surgery, the patient is admitted to the hospital in the morning and is discharged in the evening. There should be a friend or family member to take home after surgery.

It is forbidden to eat or drink anything the day before the surgery. The infant is forbidden to eat or drink anything for at least four hours before the surgery.

On the day of surgery, the patient has to come to the hospital with all the reports and papers. The patient is put on a hospital gown and after doing her final review, the nurse cleans the surgery site.

After explaining the method and risk of surgery, the patient is made to sign a form for his consent. The hair is cleaned from the site of surgery. The patient is then taken to the operation theatre.

How Hydrocele Surgery Is Done?

The patient is made to lie on his back on the operation table. A monitor is attached to the body to track heart rate, BP, etc. An IV cannula is inserted to deliver the medicines needed for the surgery.

General anesthesia is given to make the patient unconscious during the operation. Depending on the age of the patient, this surgery is done in one of the following ways:

  • In infants: Diagnosing the cause of a hydrocele, which is usually due to a weakening of the abdominal wall, a disorder in it. Where the groin bends, surgeons make a small cut to drain the fluid present in the hydrocele. The surgeon then removes the sac of the hydrocele or puts it back into the abdomen through the distorted abdominal wall. The surgeon then strengthens the abdominal wall with stitches.
  • In adults: Hydrocele fluid is removed by making a cut in the scrotum. The hydrocele is then cut off. In some cases, a hernia may also be present, so hernia repair surgery may also be performed. The cut is then closed with the help of stitches. Large hydroceles can sometimes be drained so that fluid does not build up in the scrotum.

The more modern method is laparoscopy, in which small cuts are made and a special instrument fitted with a camera is inserted to perform the surgery.

This entire process usually takes 30 minutes. After sutures, the area of ‚Äč‚Äčoperation is bandaged so that there is no bleeding.

Risks & Complications Associated With Surgery

Very few complications or problems arise from this surgery. It has some risks:

  • Heavy bleeding
  • Injury to the spermatic cord, testicular artery
  • Testicular injury
  • Infection
  • Having a hernia
  • Recurrent hydrocele
  • Discomfort caused by anesthesia

How To Care About Hydrocele Surgery

After surgery, the patient is brought from the operating theater and kept under observation for a few hours in the room. Painkillers are given to reduce the pain. A cold compress can be used to reduce irritation or inflammation.

Before discharge, the doctor prepares a discharge paper, which tells about medicines and wound care, such as:

  • If you already have a disease, whether to start its medicine or not
  • Antibiotics and pain relievers to prevent infection and pain. Children are given medicine in the form of syrup.
  • The bandage is removed after two days.
  • After surgery, cold compresses can be used for a few days to reduce swelling, but do not do more than 15 minutes at a time.
  • Wearing a jockstrap may be advised to avoid injury.
  • While bathing, clean the wound thoroughly and then dry it.
  • When the bandage is opened after two days, the patient can go about his daily activities.
  • Do not do any difficult work such as aerobic exercise or weight training for at least two weeks.
  • Do not have sex for two weeks.
  • Do not apply any cream or powder to the area until the wound is completely healed.
  • Clean and dry the sex organs after using the toilet to avoid infection. Change diapers frequently to avoid infection in babies through stool or urine.

Tell your doctor if any of the following symptoms persist or persist:

  • Heavy bleeding from the wound
  • Pus from the wound
  • Severe pain in the wound area and pain when touched
  • Sudden swelling in the wound area
  • Fever
  • Ulceration in the wound area

It takes two weeks for the wound to heal completely. The first follow-up will be after two weeks, then stitches and if there is a drain it will be removed. After this, depending on the condition of the patient, one will have to come for a follow-up.

Summary

When hydrocele shows symptoms and cosmetic discomfort, a surgery called hydrocelectomy is done as a treatment. It is a minor surgery and complications are less. New methods have come for this, such as laparoscopy taking less time to recover. After two days the patient can resume his daily activities. Despite the good success rate of surgery, the problem tends to recur.