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Baby boys sometimes have a hydrocele at birth. Hydroceles also occur in older boys and men. Sometimes they form when there is also a hernia (an abnormal bulging of tissue) present. Hydroceles are fairly common.
Surgery to repair a hydrocele is often done at an outpatient clinic, not a hospital. The patient will receive general anesthesia and will be asleep and pain-free during the procedure.
In a baby or child:
- The surgeon makes a small surgical cut in the fold of the groin, and then drains the fluid. The sac (hydrocele) holding the fluid may be removed. The surgeon strengthens the muscle wall with stitches. This is called a hernia repair.
- Sometimes the surgeon uses a laparoscope to do this procedure. A laparoscope is a tiny camera that the surgeon inserts into the area through a small surgical cut. The camera is attached to a video monitor. The surgeon makes the repair with small instruments that are inserted through other small surgical cuts.
In adults, the cut is usually made on the scrotum. The surgeon then drains the fluid after removing part of the hydrocele sac.
Why the Procedure Is Performed
Hydroceles often go away on their own in children, but not in adults. Most hydroceles in infants will go away by the time they are 2 years old.
Your surgeon may recommend hydrocele repair if the hydrocele:
- Becomes too large
- Causes problems with blood flow
- Is infected
It may also be done if there is a hernia.
Risks for any anesthesia are:
- Allergic reactions to medicines
- Breathing problems
Risks for any surgery are:
Before the Procedure
An anesthesiologist is a doctor who specializes in pain control and giving pain medicines. He or she will talk with you about your or your child’s medical history. This information helps the doctor choose the type and amount of anesthesia to use.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Also tell your doctor if you have any drug allergies or if you have had bleeding problems in the past.
Several days before surgery, adults may be asked to stop taking aspirin or other drugs that affect blood clotting. These include ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), some herbal supplements, and others.
You or your child may be asked to stop eating and drinking at least 6 hours before the procedure.
Take the medicines your doctor told you take with a small sip of water.
After the Procedure
Patients usually recover quickly. Most can go home a few hours after surgery. Children should take it easy and rest more than usual the first few days after surgery. Normal activity can usually start again in about 4 to 7 days.
The success rate for hydrocele repair is very high. The long-term prognosis is excellent, but another hydrocele may form over time, or if there was also a hernia present.
Elder JS. Disorders and anomalies of the scrotal contents.In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 539.
Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010. 37(3):613-626.
Kavoussi PK, Costabile RA. Surgery of the scrotum and seminal vesicles. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa:Saunders Elsevier; 2011:chap 37.
Barthold JS. Abnormalities of the testes and scrotum andtheir surgical management.In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 132.
Aiken JJ, Oldham KT. Inguinal hernias. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 338.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.