What Is a Hydrocelectomy?

A hydrocele is a benign, non-cancerous collection of fluid surrounding the testicle. It is located within the outer layer of the testicle called the tunica vaginalis. Hydroceles can also develop due to inflammation or injury within the scrotum.

The usual symptoms of a hydrocele include scrotal swelling, which can fluctuate throughout the day, as well as discomfort due to the increase size of the scrotum.

Many men do not know they have hydroceles and are asymptomatic. Most of the time observation is acceptable instead of treatment. We still recommend that you visit with your doctor to get an ultrasound done of the scrotum.

We hate to burst your bubble, but in some cases hydroceles will need to be aspirated or surgically removed. Needle aspiration is an in-office procedure to remove the fluid within the capsule, but does not remove the surrounding capsule itself. We first do a scrotal ultrasound to determine the location of the fluid and testicle. Next, a numbing medication is applied, and a needle is inserted into the scrotum. The fluid is then drained with the needle. Since the surrounding capsule stays in place, there is a 30-40% likelihood that the hydrocele may return.

Surgical treatment of a hydrocele involves removal of the entire surrounding capsule with fluid. This is an outpatient procedure, meaning you go home the same day, and is done under general anesthesia in the operating room. To remove the hydrocele, an incision is made in the scrotum. The hydrocele is removed, along with the tissues involved in creating the hydrocele. The small incision of the scrotum is closed with absorbable sutures. If there are complications, such as a hernia, an incision is made in the inguinal (groin) area. This approach allows repair of hernias and other complicating factors at the same time.

Surgery is generally an effective treatment for hydrocele, though a small percentage of patients do have recurrence. A hydrocelectomy is typically a 45-minute procedure done on an outpatient basis.