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Hydrocele repair

Hydrocelectomy

Hydrocele repair is surgery to correct the swelling of the scrotum that occurs when you have a hydrocele. A hydrocele is a collection of fluid around a testicle.

Baby boys sometimes have a hydrocele at birth. Hydroceles also occur in older boys and men. Sometimes they form when there is also a hernia (an abnormal bulging of tissue) present. Hydroceles are fairly common.

Description

Surgery to repair a hydrocele is often done at an outpatient clinic. General anesthesia is used so you will be asleep and pain-free during the procedure.

In a baby or child:

  • The surgeon makes a small surgical cut in the fold of the groin, and then drains the fluid. The sac (hydrocele) holding the fluid may be removed. If needed, the surgeon strengthens the muscle wall with stitches. This is called a hernia repair.
  • Sometimes the surgeon uses a laparoscope to do this procedure. A laparoscope is a tiny camera that the surgeon inserts into the area through a small surgical cut. The camera is attached to a video monitor. The surgeon makes the repair with small instruments that are inserted through other small surgical cuts.

In adults:

  • The cut is most often made on the scrotum. The surgeon then drains the fluid after removing part of the hydrocele sac.

Needle drainage of the fluid is not done very often because the problem will always come back.

Why the Procedure Is Performed

Hydroceles often go away on their own in children, but not in adults. Most hydroceles in infants will go away by the time they are 2 years old.

Your surgeon may recommend hydrocele repair if the hydrocele:

  • Becomes too large
  • Causes problems with blood flow
  • Is infected
  • Is painful or uncomfortable

The repair may also be done if there is a hernia associated with the problem.

Risks

Risks of any anesthesia are:

  • Allergic reactions to medicines
  • Breathing problems

Risks of any surgery are:

  • Bleeding
  • Infection
  • Blood clots
  • Recurrence of the hydrocele

Before the Procedure

Tell your surgeon or nurse if:

  • You are or could be pregnant
  • You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
  • You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

  • If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
  • If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
  • If needed, prepare your home to make it easier to recover after surgery.
  • Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

  • You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
  • Ask your surgeon which medicines you should still take on the day of surgery.
  • Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed.

After the Procedure

Recovery is quick in most cases. Most people can go home a few hours after surgery. Children should limit activity and get extra rest in the first few days after surgery. In most cases, normal activity can start again in about 4 to 7 days.

Outlook (Prognosis)

The success rate for hydrocele repair is very high. The long-term outlook is excellent. However, another hydrocele may form over time, especially if a hernia was present.

Open References

References

Di Carlo HN, Crigger CB. Disorders and anomalies of the scrotal contents. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 582.

Hawksworth DJ, Khera M, Herati AS. Surgery of the scrotum and seminal vesicles. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 83.

Palmer LS, Palmer JS. Management of abnormalities of the external genitalia in boys. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 44.

  • Hydrocele

    Hydrocele - illustration

    A hydrocele is a collection of fluid inside the area of the scrotum, surrounding the testicle. Hydroceles are common in newborn infants and normally resolve after a few months after birth. The main symptom is a painless, swollen testicle, on one or both sides, which feels like a water-filled balloon. Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they threaten the blood supply of the testicle.

    Hydrocele

    illustration

  • Hydrocele repair - series

    Hydrocele repair - series

    Presentation

    •  
  • Hydrocele

    Hydrocele - illustration

    A hydrocele is a collection of fluid inside the area of the scrotum, surrounding the testicle. Hydroceles are common in newborn infants and normally resolve after a few months after birth. The main symptom is a painless, swollen testicle, on one or both sides, which feels like a water-filled balloon. Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they threaten the blood supply of the testicle.

    Hydrocele

    illustration

  •   Hydrocele repair - series

    Hydrocele repair - series

    Presentation

    •  
 

Review Date: 1/1/2025

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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