Hydrocele operation

What is a hydrocele?

A hydrocele is a collection of fluid in a sac around or above the testicle.

Unlike in adults the fluid comes from the tummy through a fine tube (called a ‘patent processus vaginalis’). This tube did not close off after the testicle descended from the tummy to the scrotum.

Why does this operation need to be done?

Hydroceles are common in babies and most will disappear by themselves. If they have not gone by around the age of 5 years they are very unlikely to get better.

The aim of the operation is to get rid of the fluid and disconnect the tube which allows the fluid down from the tummy.

What would happen if nothing was done?

If nothing was done, then the swelling would remain. The hydrocele does not harm the testicle and usually does not cause discomfort, so it does not have to be treated. However, the swelling can be quite large and may cause embarrassment for older children.

What does the operation involve?

Under a general anaesthetic a small cut is made in the groin area. From there, the tube is found and tied off. Fluid from around the testicle is drained.

All the stitches are buried under the skin and dissolve so they do not need to be removed later.

What will happen afterwards?

Recovery from the operation is usually rapid, especially in younger children. The area will be sore for a couple of days but this can be helped with regular paracetamol.

Children are usually back to normal activity within a few days. Older children may experience more discomfort and will need to stay away from active sports (except swimming) for 2 to 3 weeks.

What complications can occur from the surgery?

Because the patent processus (the fine tube in the tummy) is close to the blood vessels to the testicle and the tube that carries sperm in boys (the vas), these can get damaged in the surgery. This is rare at around 1 in 100 to 1 in 200 operations.

If this happens the testicle may not grow properly if the blood supply was damaged. If the vas is damaged the testicle may become infertile.

Sometimes the testicle can get caught in scar tissue and pulled back into the groin. This is also rare and only happens in 1 in 100 operations.

The chance of the hydrocele happening again is rare (less than 1 in 100) but it may require more surgery if it did.

Bleeding and bruising can also occur but this should get better by itself.

Sometimes the wound can become infected and this may need a course of antibiotics to treat it.

Will there need to be any medical check up after surgery?

The vast majority of these operations happen without a problem and the wounds heal well. Because of this your child may not need to be seen again after the operation, but this depends on the surgeon doing the operation.