What is a Hydrocele?
The scrotum contains two testes that are surrounded by protective tissue containing fluids to allow them to move freely.

Normally any excessive fluid simply drains away into the scrotum. If problems occur that disrupt this process, fluid can accumulate as a hydrocele.

A hydrocele feels like a small balloon that is full of fluid. It feels smooth and is painless, but if untreated can grow uncomfortably large making some physical activity unnecessarily irritating. Hydroceles do not damage the testicle and have no impact on fertility.

What causes this build up of scrotum fluid?
In a small number of cases a hydrocele can occur as a result of testes-related problems such as infection or injury. However, in most instances the cause is not known.

What treatment options are available?
Aspiration is one method. This involves the draining of excess fluid with a needle and syringe after local anaesthetic. This procedure is straightforward but there is always a chance that the hydrocele may refill.

Another method is to remove the hydrocele under general anaesthetic. Once this has been achieved the fluid-secreting surface is in contact with the inner skin of the scrotum which absorbs any excess fluid.

A more successful procedure is a combination of aspiration or surgical excision with an injection of sclerosing agent.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

It is important that you make an informed decision before signing the surgery consent form so ask plenty of questions. You want to feel relaxed, confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before general anaesthetic (if you require it).
• The surgeon and anaesthetist need to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing.

After surgery

• You will feel temporary bruising and tenderness.
• The testicle and scrotum may stay swollen for a couple of weeks. This will settle in time.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with a mild analgesic like Paracetamol. Do not use aspirin.

All surgery carries an element of risk
Most people believe that the benefits of this type of surgery far outweigh the risk. However before you sign the surgery consent form you should be aware of possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Complications are rare and depend greatly on individual circumstances such as a person’s health and the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.