Hydrocelectomy

Definition

Hydrocelectomy is a surgical procedure to remove a hydrocele. A hydrocele is collected fluid in the membrane surrounding the testes.

Purpose

Hydrocelectomy is performed to relieve the pain or reoccurrence of a hydrocele. Normally, hydroceles are not very painful. They tend to be a soft swelling in the membrane surrounding the testes. As the hydrocele grows, the scrotum gets larger. Hydroceles do not damage the testes. The main symptom is scrotal swelling. There are two types of hydroceles depending on how they form. One type is seen in children, generally shortly after birth. It is caused by a failure of the processus vaginalis to close. Usually, surgery isn't used to treat hydrocele until after two years of age because the processus vaginalis frequently closes by itself if given extra time. In adults, hydroceles develop slowly. Most hydroceles develop because of blocked lymphatic flow. Hydroceles also develop after infection, injury, or local cancer tumors. Generally, hydroceles are treated by aspiration of the collected fluid. To do this, a needle is inserted into the scrotum and directed toward the hydrocele. Once there, as much fluid as possible is removed. Hydroceles can reoccur. Rarely, hydroceles grow larger and cause pain. Surgery is used to remove large or painful hydroceles. It is also the recommended procedure to remove hydroceles that reoccur after aspiration. Hydroceles are distinguished from other testicular problems by transillumination and scrotal ultrasound examinations.

Precautions

No special precautions are required for hydrocelectomy. It is typically performed on an outpatient basis.

Description

Aspiration of the fluid in a hydrocele is usually successful. However, aspiration may be only a temporary solution because of the potential that the hydrocele will reoccur. Generally, surgical repair of a hydrocele will eliminate the hydrocele. The extent of the surgery depends on whether other factors are present. If the hydrocele is uncomplicated, an incision is made in the scrotum. The hydrocele is cut out, removing the tissues involved in the hydrocele. If there are complications present, such as a hernia, an incision is made in the inguinal (groin) area. This approach allows repair of hernias and other complicating factors at the same time. Patients are placed under general anesthesia for these operations.

Preparation

A physician or nurse will explain the procedure and, in some cases, the need for a temporary drain to be inserted. The drain lessens the chance of infection and prevents fluid build- up.

Aftercare

Following surgery, the patient usually only needs a follow-up examination several weeks after the surgery to examine the incision and to check for signs of infection.

Risks

There is a slight risk of infection and internal hemorrhage as well as a chance of excessive bleeding from the surgical incision.

Normal results

There may be swelling of the scrotum for up to a month. The patient is able to resume most activities within 7-10 days, although heavy lifting and sexual activities may be delayed for up to six weeks. The hydrocele does not grow back.

Abnormal results

Swelling that lasts for several months is sometimes a complication of hydrocelectomy. Infection can also occur.

Key Terms

Aspiration

The process of removing fluids or gases from the body by suction.

Hernia

The protrusion of an organ or tissue through a wall that normally contains it.

Hydrocele

An accumulation of fluid in the membrane surrounding the testes (tunica vaginalis testis).

For Your Information

Books

• Hurst, J. Willis. Medicine for the Practicing Physician. Stamford: Appleton & Lange, 1988.

• Sabiston, D. C., and H. K. Lyrly. Essentials of Surgery. Philadelphia: W. B. Saunders Co., 1994.

• Current Surgical Diagnosis and Treatment. 10th ed. Ed. Lawrence W. Way. Stamford: Appleton & Lange, 1994.

Source: Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group

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