Hydroceles are usually not dangerous, and they are usually only treated when they cause discomfort or embarrassment, or they get so large that they present a threat to the testicular blood supply. Treatment options include needle aspiration of the fluid or surgery. Recurrence of the hydrocele is common if aspiration is performed.
Hydroceles associated with an inguinal hernia should be repaired surgically as quickly as possible. Hydroceles that do not resolve spontaneously over a period of months should be evaluated for possible surgery.
MEDICATIONS: Injection of sclerosing (thickening or hardening) medications (such a tetracycline, sodium tetradecyl sulfate, or urea) may be performed after needle aspiration to obliterate (close off) the opening through the scrotal sac and thus prevent re-accumulation of fluid. Possible complications after aspiration and sclerosing include infection, fibrosis, mild to moderate pain in the scrotal area, and recurrence of the hydrocele.
SURGERY: Hydrocelectomy is the surgical procedure often performed to correct a hydrocele. This is a minor surgical procedure that is performed on an outpatient basis using general or spinal anesthesia. An incision may be made in the scrotum or the lower abdomen.
The procedure may require a scrotal drainage tube or a large bulky dressing to the scrotal area. You will be advised to wear a scrotal support for some time after surgery. Ice packs should be kept to the area for the first 24 hours after surgery to reduce the swelling in the area.
Possible complications of this procedure include hematoma (blood clot formation), infection, or injury to the scrotal tissue or structures.
ASPIRATION: Aspiration (removal of fluid with a needle) of the fluid in the scrotum is another possibility. Surgery is generally preferred over this option. Aspiration can cause infection, and the fluid frequently re-accumulates. Aspiration, however, may be the best alternative for people who are poor surgical risks.
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