Hydrocele Surgery and Recovery Process

Commonly known as water hernia, swelling of the bags, and fluid accumulation, hydrocele is particularly prevalent in newborns.

Commonly known as water hernia, swelling of the bags, and fluid accumulation, hydrocele is especially common in newborns. In males, the scrotum, which houses the sperm, is covered by a protective sheath made of a double-layered membrane. Between these layers is a small amount of fluid that allows sperm to move more freely and provides easier protection against external factors. This fluid is secreted by one of the layers and absorbed by the others. Under normal circumstances, this process is balanced. When the balance is disrupted, an increase in the amount of fluid between the layers is observed, causing the scrotum to swell and form a filled sac. This sac is referred to as a hydrocele.

How Does Hydrocele Occur and What Are Its Causes?

Hydrocele is classified into two types: congenital (birth-related) and adult hydrocele.

Congenital Hydrocele: During pregnancy, a baby's testicles are located in the abdomen. After the 14th week of gestation, they progress downwards into the scrotum, which is the pouch that holds the testicles. The journey of the testicle to the scrotum is accompanied by the peritoneum (abdominal lining), which takes on a glove-like shape. After birth, the sac-like form of the peritoneum transforms into a thread-like structure and closes. If the sac does not close, abdominal fluid can pass through the opening and accumulate around the testicle, causing swelling. This swelling, referred to as hydrocele, is a congenital problem in newborns; however, circulatory disorders, infections, and tumors can also lead to hydrocele.

Adult Hydrocele:

Hydrocele is generally observed in men over the age of 40 and can occur due to factors such as radiotherapy, varicocele surgeries, testicular tumors, inflammatory diseases of the testis, and trauma to the scrotum. In cases of kidney transplantation, unilateral hydrocele formation is observed in 70% of patients.

How Is Hydrocele Diagnosed?

The frequency of hydrocele increases with age, and it is a benign condition that does not develop into cancer. A painless swelling in the testicles that gradually increases over time is among the symptoms of hydrocele. Depending on the size of the swelling, whether it causes pain, and the patient’s aesthetic concerns, hydrocele may be monitored or treated. Hydrocele in children is often accompanied by a hernia. In cases of hydrocele associated with a hernia, immediate surgical intervention is recommended. In the case of isolated hydrocele, treatment can be deferred until the child is 2 years old, considering the possibility of spontaneous resolution. During the physical examination of hydrocele, light is shone on the swollen sacs, and if the light is transmitted, it indicates that the sacs are filled with fluid. Lack of light transmission may indicate the development of a tumor within the sacs.

Hydrocele Treatment

For hydrocele occurring in childhood, observation is typically continued until the age of 2, and if there is no spontaneous resolution, surgical treatment is recommended. During hydrocele treatment, circumcision is often performed as well. The surgical procedure for adult hydrocele lasts approximately 30-60 minutes. After the procedure, a drain is placed in the pouch, and the patient is usually monitored for 24-48 hours. After the drain is removed, the patient is discharged. It is recommended that the patient rests at home for a few days after hydrocele treatment. Within 7 days, the patient’s stitches dissolve, and they can bathe. Special underwear that supports the elevation of the pouch is recommended to be worn continuously for 7 days. During the first week after the surgical procedure, painkillers, antibiotics, and anti-inflammatory medications are usually administered. The patient can engage in sexual intercourse two weeks after the operation and participate in sports activities four weeks later.