Hydrocele

A hydrocele is an abnormal collection of fluid around the testicle. It is generally not dangerous and does not need to be treated unless it is symptomatic and causing discomfort. It is unclear why it occurs and sometimes is idiopathic (no clear cause).

Generally no a hydrocele is not dangerous. We often obtain a scrotal ultrasound to ensure there are no testicular masses which would likely warrant evaluation.

Options include observation, needle aspiration (very high recurrence risk), and surgical hydrocelectomy.

Yes, especially if the hernia being operated on is an inguinal hernia, we can remove the hydrocele at the same time.

There are a variety of surgical techniques for removing hydroceles:

• Trans-inguinal approach: useful if done at the time of an open inguinal hernia repair.

• Trans-scrotal approach: most direct approach and useful if done as a single procedure.

Dr. Cober tends to favor doing a trans-inguinal approach at the same time of an open inguinal hernia repair. To keep post-op swelling and complication risks down, he tends to favor a minimal dissection, fenestrating hydrocelectomy.

References:

• Rowe et al, "The Western snip, stitch, and tug hydrocelectomy: How I do it" https://pubmed.ncbi.nlm.nih.gov/27695592/

• Ziegelmann et al, "Office-based, Minimal-Incision Modified Fenestration Technique for Symptomatic Hydroceles Under Local Anesthesia" https://pubmed.ncbi.nlm.nih.gov/31626858/

There are no additional restrictions with lifting or activities. A bulky scrotal support dressing will be kept on for 2 weeks after surgery and can be removed for the bathroom but should otherwise remain in place to minimize swelling.