Hydrocele – Symptoms, Diagnosis and Laser Surgery

A hydrocele is a condition in the scrotum. It is a type of swelling that occurs when fluid collects in the thin sheath surrounding a testicle. Hydroceles are common in new-born babies and they usually disappear without treatment by the age of one.

They can also occur at any age; adult men or old boys can develop a hydrocele due to inflammation or injury within the scrotum. In general, hydroceles do not pose any threat to the human body. They disappear without treatment. However, if you have scrotal swelling, you must visit your doctor to rule out other causes such as testicular cancer.

What causes hydrocele?

Hydroceles can be caused by excess production of fluid or decreased absorption. They are formed usually in men over 40 and usually occurs if the channel through which the testicles descend as a baby hadn’t closed all the way. Hydroceles can also be caused by inflammation or injury in the scrotum or along the channel.

In countries like India, hydrocele can occur due to an infection like Filariasis which is endemic. Some fluid collections could be blood due to bleeding inside the layers which results from trauma.

Symptoms of hydrocele 

Hydroceles usually do not cause pain. The only indication of a hydrocele is a painless swelling of one or both testicles. Adult men may feel heaviness in the scrotum. In some cases, the swelling might be worse in the morning than in the evening.

Seek immediate medical attention if sudden, severe scrotal pain or swelling develops especially within several hours of an injury to the scrotum. The signs and symptoms can occur with a number of conditions like blocked blood flow in a twisted testicle. This condition known as Testicular torsion must be treated within hours of the onset of signs and symptoms to save the testicle.

Complications of Hydrocele

Hydroceles are usually complications—less and aren’t dangerous. But a hydrocele might be associated with an underlying condition that causes serious complications such as

• Inguinal Hernia
• Infection or tumour

Diagnosis of hydrocele 

A doctor can diagnose a hydrocele through various tests and observations such as

• Testing for tenderness in an enlarged scrotum
• Applying pressure to the abdomen and scrotum checking for inguinal hernia
• Testing how the bulge in the groin changes under pressure when the patient is asked to cough
• Shining a light through the scrotum, highlighting any fluid in that area
• Blood or urine tests to rule out infections
• Ultrasound to rule out hernia, tumour or other causes of swelling

How is this condition treated?

There are no drugs to treat adult hydrocele, although pain medication is administered to help prevent any discomfort.

Sometimes surgery may be needed to repair or drain a hydrocele. This usually happens when there is an infection or if the hydrocele becomes too large threatening normal functioning of other structures in the scrotum. Your doctor may suggest surgery if the ultrasound shows more than a hydrocele. The tissue of your hydrocele may be sent to the lab for diagnosis.

Surgery for a hydrocele is done by making a cut in the scrotum or the groin area near the scrotum to drain the accumulated fluid. This procedure is done on an out-patient basis and under general anaesthesia.

LASER SURGERY FOR HYDROCELE 

Conventional surgery for hydrocele can pose a lot of threats and complications such as blood clots, scrotal injury or heavy bleeding. Due to advancements in technology the surgery can now be performed with lasers.

With the advent of the Holmium YAG laser at chennai laser gastro clinic, the laser excision of the sac technique is applied with excellent results. The possibility of blood loss is very less, with the use of YAG laser the blood loss in patients is minimal (less than 5ml) and the pain is inexistent. The patient can go home in 6 hours and can expect quicker and better recovery with fewer chances of infection and blood clots.

Post-surgery care

If you have had surgery for your hydrocele, the pain will probably go away in a week. Your doctor may prescribe pain medicines if you are in need. You need to hold on to your normal activities such as riding a bike for at least three weeks. Strenuous activities must be avoided too.

If you do have stitches at the incision site, they may dissolve on their own. Keep the area clean using showers or sponge baths to prevent injection. Consult with your doctor after a few weeks.