Hydrocele Treatment in Delhi, India

The most noticeable symptom of a hydrocele is visible swelling in the scrotum. Other symptoms may include a sense of fullness or pressure in the scrotum, pain or discomfort (especially with larger or infected hydroceles), reduced testicular size, difficulty with physical activity, tenderness to the touch, scrotal redness or warmth (in case of infection), foul-smelling discharge (if infected), fatigue, and difficulty sleeping.

There are various causes of hydrocele, including:

• Congenital defects: Hydroceles can occur in infants due to a failure of the processus vaginalis (the passage through which the testicles descend into the scrotum during fetal development) to close properly.

• Injury or trauma: Trauma to the testicles or surrounding structures can lead to the development of a hydrocele. This can be caused by sports injuries, surgical complications, or accidents.

• Inflammation or infection: Inflammation or infection of the testicles or surrounding structures can result in a hydrocele. Conditions such as epididymitis, orchitis, and testicular torsion can contribute to the development of a hydrocele.

• Tumours: Tumors in the testicles or surrounding structures, both benign (e.g., spermatocele) and malignant (e.g., testicular cancer), can cause a hydrocele to develop.

• Age-related changes: As men age, the fluid-producing cells in the testicles may become less active, leading to fluid accumulation and the development of a hydrocele.

• Blockages: Blockages in the flow of fluid in the testicles, such as in the spermatic cord or lymphatic vessels, can cause a hydrocele.

• Idiopathic: In some cases, the cause of a hydrocele is unknown (idiopathic). These hydroceles are usually benign and do not require treatment.

Hydrocele can be classified into two different types, including: 

1. Communicating hydrocele: This type of hydrocele occurs due to the failure of the processus vaginalis, which is a thin membrane that extends through the inguinal canal into the scrotum. The sac surrounding the testicle does not seal, allowing fluid to flow in and out. Communicating hydrocele can also lead to hernias. 
2. Non-communicating hydrocele: This is another type of hydrocele. It occurs when the inguinal canal closes, but there is extra fluid around the testicles in the scrotum. The body generally absorbs the remaining fluid within a period.

Diagnosis of hydrocele involves various tests and observations, including:

• Physical exam: The doctor examines the scrotum for tenderness and may shine a light on it to check for fluid accumulation.

• Tests: Blood or urine tests may be conducted to check for infections.

• Ultrasound: This imaging test can be performed to evaluate the scrotum and identify any hernias, tumours, or other causes of scrotal swelling.

In most cases, hydroceles resolve on their own and do not require treatment. However, if a hydrocele causes discomfort or is a communicating hydrocele, treatment options include:

Surgery (Hydrocelectomy)

A surgical procedure performed under anaesthesia to remove the hydrocele. The surgeon makes a small incision in the abdomen or scrotum, depending on the location of the hydrocele, and removes it surgically.

In most cases, hydrocele does not pose any serious risk and affect fertility. However, in rare cases, hydrocele can result in an inguinal hernia, which can cause dangerous complications. This happens when a loop of the intestine sticks out through a weak spot in the abdominal wall and gets trapped. 

Prevention measures for hydrocele include:

• Avoiding injuries to the testicles and surrounding structures

• Prompt treatment of infections or inflammation in the testicles

• Regular self-examination of the testicles for any unusual changes or swelling

• Seeking medical attention if any scrotal abnormalities or symptoms arise

• Ensuring proper genital hygiene to minimise the risk of infections

Recovery from hydrocele depends on the underlying cause and severity of the condition. In newborns, hydroceles typically resolve within the first year of life. In adults, surgical treatment usually provides effective resolution, but recovery may take several weeks and involve discomfort or pain.

The outlook for hydrocele is generally good, and with proper treatment and care, most individuals will make a full recovery without further issues. Complications such as infection, bleeding, infertility, chronic pain, and psychological distress are rare.

1. Will a hydrocele go away by itself?

A hydrocele may go away on its own, particularly in infants and young children. However, it is important to consult a doctor for proper diagnosis and treatment, as some hydroceles may require surgery. In some cases, a hydrocele may not go away on its own and may require treatment.

2. Can hydrocele surgery cause infertility, erectile dysfunction, or low testosterone?

Hydrocele surgery, also known as a hydrocelectomy, is a procedure to remove a fluid-filled sac in the scrotum. This condition is usually benign and is not associated with infertility, low testosterone, or erectile dysfunction. However, as with any surgical procedure, there is a small risk of complications such as infection, bleeding, or damage to surrounding tissue. If a man experiences any of these symptoms after surgery, it is important to consult with his surgeon. Overall, the majority of men who undergo hydrocele surgery do not experience any negative effects on their fertility, erectile function, or testosterone levels.

Reviewed by Dr. Gaurav Garg (Uro), Senior Consultant - Urology, Urology, Robotic Surgery on 17-July-2023.

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