What is Hydrocele?
Hydrocele is defined as the accumulation of fluid between the membranes surrounding the testicles. It can be caused by varicocele surgery, inguinal hernia repair, or past testicular infections, and in some cases, underlying testicular cancer may also lead to hydrocele. Therefore, any patient who notices swelling in the testicles should consult a urologist. In some hydrocele cases, no specific cause can be identified.

It is usually a cosmetic concern, causing discomfort in activities such as wearing pants or swimming. In some cases, it may also cause pain.

What is Hydrocele Surgery?
Hydrocele occurs when excess fluid accumulates inside the scrotal sac, causing swelling. During fetal development, the testicles are initially located inside the abdomen and gradually move down into the scrotum before birth. When this process is disrupted, hydrocele may develop, necessitating surgical intervention.

The modern surgical approach involves removing the tunica vaginalis membrane. The procedure is performed by excising the outer layer of the sac, then either stitching the edges together or turning the fluid-producing part outward and suturing it to eliminate the sac.

How is a Hydrocele Examination Performed?
A hydrocele examination is typically conducted by a medical professional, such as a doctor or nurse practitioner. The patient is usually asked to undress and lie on an examination table. The healthcare provider then gently palpates the scrotum to check for fluid-filled sacs.

A transilluminator, a device that shines light through the scrotum, may also be used to make the sacs more visible. If necessary, a small sample of fluid may be taken for further testing. The examination is generally painless and takes only a few minutes.

How is Hydrocele Surgery Performed?
Hydrocele occurs when an excessive amount of fluid collects within the membrane surrounding the testicles. In Izmir, hydrocele is commonly known as a "water hernia."

During the surgery, an incision is made on the scrotal sac, and once the fluid-filled sac is reached, the fluid is drained. The procedure is usually performed under spinal anesthesia, numbing the lower half of the body.

After draining the fluid, a small drain is typically placed and removed the following morning. The patient can return to daily activities after a few days of rest. Potential complications include swelling and infection in the testicles, though these are rare.

Hydrocele surgery provides a definitive cure for the condition. The procedure can be performed using various techniques, depending on the patient’s age. Most patients are discharged shortly after the surgery. Postoperative follow-up with a doctor is recommended.

How Much Does Hydrocele Surgery Cost in Izmir?
For information on hydrocele surgery prices in Izmir, please contact us.

Frequently Asked Questions

How Long Does It Take to Recover from Hydrocele Surgery?
The surgery typically lasts 30–60 minutes. After the procedure, a drain is placed in the scrotum, and the patient is monitored for 24–48 hours. The drain is removed, and the patient is advised to rest at home for a few days. Stitches dissolve within seven days, allowing the patient to bathe. Special supportive underwear should be worn for seven days to keep the scrotum elevated. Pain relievers and antibiotics are prescribed for the first week. Patients can resume sexual activity after two weeks and engage in sports after four weeks.

When Should an Adult Undergo Hydrocele Surgery?
Hydrocele is most commonly seen in men over 40 and can develop due to radiation therapy, varicocele surgery, testicular tumors, testicular infections, or scrotal trauma. It is a benign condition and does not turn into cancer. A painless swelling that gradually enlarges over time is a key symptom. Treatment depends on the swelling size, pain levels, and cosmetic concerns.

Is Hydrocele Surgery Necessary?
In children, hydrocele is monitored until age two; if it does not resolve on its own, surgery is recommended. Hydrocele repair is often performed alongside circumcision. In adults, the condition is monitored based on swelling size, pain, and aesthetic concerns. If hydrocele occurs with a hernia, immediate surgical intervention is required.

Can Hydrocele Resolve Without Surgery?
Yes, hydrocele can sometimes resolve without surgery. Non-surgical treatment involves draining the fluid using a needle, but since the tunica vaginalis is not removed, fluid production continues. This procedure may need to be repeated every 6–12 months. A chemical solution can be injected to reduce fluid production, but this method is painful and is generally used for elderly patients. It does not provide a permanent cure.

Is Hydrocele Harmful?
The age of the patient is an important factor in evaluating hydrocele. If the patient is under 35, the swelling develops rapidly, and there is no history of trauma, an ultrasound examination should be performed. If no abnormalities are detected in the testicle and blood tests for tumors are negative, the condition is considered a benign hydrocele. However, if abnormalities are found, urgent surgical intervention may be necessary to rule out testicular cancer.

What Causes Hydrocele Symptoms?
If the opening between the abdomen and the scrotum does not close properly after birth, abdominal fluid can accumulate in the scrotum, causing swelling. If the opening is large, abdominal organs may protrude, leading to a hernia. In adults, hydrocele can develop due to trauma, infections, testicular tumors, varicocele surgery, or radiation therapy. Up to 70% of kidney transplant patients may develop hydrocele in one testicle.

How Large Can a Hydrocele Get?
Hydrocele occurs when excessive fluid accumulates between the layers surrounding the testicles. It is commonly known as "water hernia" or "fluid accumulation" in the scrotum. Normally, 0.5 to 1 ml of fluid is present between the testicle and these membranes for lubrication. In hydrocele cases, this amount can increase to 100–200 ml or even more in some patients.

Sources:

• Cleveland Clinic - Hydrocelectomy
• Esen, B., Sarıdemir, S., Guleryuz Bolsu, G., & Doğanözü, A. C. "Adult Spermatic Cord Hydrocele: Case Report and Literature Review." ACTA ONCOLOGICA TURCICA, 53(3), 543-546.