A hydrocele testis is a type of a cyst that forms around the testicle. Usually it forms an oval structure surrounded by the testicle layers, which also form a hydrocele wall. This condition may be congenital or acquired and it affects men of all ages. The most common causes of hydrocele formation include: the history of scrotum injury, inflammation of testicles or epididymis, inguinal hernia repair and varicocele surgical treatment. Symptoms of hydroceles occur only in some patients and are related to the amount of accumulated fluid. Patients usually complain of:
- unilateral (less commonly bilateral) scrotum enlargement;
- discomfort, sense of pressure and pain in the scrotal region;
- restriction in movements and physical activity.
In very rare cases, especially in patients with large hydrocele and long term history, the testicles atrophy and impaired sperm production may appear.
Surgical removal of hydrocele testis is a urological procedure performed under spinal anesthesia. The operation involves transverse incision of the scrotum, dissection and release of hydrocele with its removal from the scrotum. Then, the incision of hydrocele sac is performed and the fluid is evacuated. The excess of testicular sheaths is cut off. At the end of the procedure, a drainage is placed in the lower pole of the scrotum and the scrotum is sewn together.
The operation time depends on the size of hydrocele, but it usually takes about 30 to 40 minutes. Due to the spinal anesthesia, a urinary catheter will be left after the procedure and removed on the same day in the evening or the next morning. After the surgery, a special dressing that lifts and compresses the scrotum is placed. If no complications appear, the drainage is removed the next day and patient is discharged home.
Postoperative recommendations:
- Maintaining the scrotum elevation for about 3 weeks;
- Urological control visit 10 days after the surgery in order to remove skin sutures.
