What is a hydrocele?

A hydrocele is a swelling around the testicle caused by a collection of fluid. It is a common problem in children.

All boys have a connection between their abdomen and their scrotum before they are born.

By birth, this connection is usually closed. If it stays open, the fluid that surrounds the bowel may trickle down and collect in the scrotum.

What are the benefits of surgery?

Your child should no longer have the hydrocele. Surgery should prevent your child from having discomfort or embarrassment caused by having the hydrocele or it getting larger as he gets older. In some cases hydroceles become hernias so the procedure will stop this from happening.

Are there any alternatives to surgery?

A hydrocele improves over time, as the connection will often close within the first few years of life. Surgery is usually recommended if the connection has not closed by the time your child is 2 to 3 years old.

What will happen if I decide that my child will not have the procedure?

If the hydrocele does not get better, it may get larger. This may cause discomfort or embarrassment. There is also a risk that your child may develop a hernia later in life.

What does the procedure involve?

The procedure is performed under a general anaesthetic and usually takes about an hour.

Your surgeon will make a cut on the groin.

Your surgeon will find the connection, which is stuck on to the blood vessels that supply the testicle and on to the vas, the tube that will carry sperm away from the testicle. Your surgeon will peel the connection away from these tubes before tying it off.

What complications can happen?

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of children who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for your child.

Some complications can be serious and may even cause death.

General complications of any procedure

• Bleeding during or after the procedure.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.

Specific complications of this procedure

• Developing a collection of blood (haematoma) or fluid (seroma) under the wound or in the scrotum.
• Damage to nerves that supply the skin around the groin, leading to a numb patch or continued pain.
• Damage of the blood supply to the testicle. The testicle on the same side as the procedure may shrink and not work.
• The problem coming back. Your child may need another procedure to fix it.
• Damage to the vas. This is rare. Any damage is usually repaired during the procedure but the vas may not be able to carry sperm.

Consequences of this procedure

• pain
• unsightly scarring of the skin

What happens after the procedure?

He should be able to go home the same day.

Your child will usually be well enough to return to school after around 3 days.

Most children make a full recovery and can return to normal activities.

Summary

A hydrocele is a common condition where fluid collects around a testicle. Surgery is usually recommended if a hydrocele continues beyond the second year of life. If left untreated, a hydrocele can get larger and is unlikely to get better.

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