The testes play a key role in the development of male sex hormones namely, testosterone. The hormone assists with sperm production. The testis is contained in a sac-like structure known as the scrotum. It is in turn surrounded by three different layers of tissues. The outermost layer is known as tunica vaginalis. There are two membranes that surround this particular layer: an inner layer and an outer layer. A ‘lubricating’ fluid flows freely between the outer and inner layers. When there is an excessive accumulation of the lubricating fluid, it can lead to a hydrocele.
Hydrocele is coined from the Greek word ‘hydro’ and ‘cele’ which when translated to English mean ‘fluid’ and ‘swelling’ in that order. In other words, hydrocele refers to a swelling of the scrotum after an unusual collection of clear or yellowish fluid. The condition is especially common among newborn males. A hydrocele can look or sound serious, but this is not always the case. You are also likely to imagine that your baby is in a lot of pain. However, the condition does not pose any major health problem. Nonetheless, it can be a source of embarrassment, not to mention it makes one feel uncomfortable.
A hydrocele is more prevalent in male infants as compared with adults. It affects one in 10 male infants compared to about 1 percent of adult males. In particular, a hydrocele is more common in older males. India has a higher prevalence of hydrocele in adult males primarily due to filarial infection, accounting for nearly 43 percent of the cases.
Causes of hydrocele
In the early stages of pregnancy, the male child’s testicles are usually located in the abdomen. However, they will descend into the scrotum during the last trimester. The scrotum closes naturally as part of the baby’s development. This happens during the baby’s first year of life. In the case of a hydrocele, however, the sac does not close. One of the risk factors identified for a hydrocele in babies is being born prematurely.
Your testicles are surrounded with fluid. Under normal circumstances, such fluid is absorbed once the sac closes. Under certain situations, however, the sac may fail to close and not all the fluid gets absorbed. Any remaining fluid should be absorbed gradually over the next 12 months after birth. At times, though, the sac does not close completely. This is known as a communicating hydrocele. In case the scrotal sac gets compressed or there has been a change in the size of the sac, this might trigger the backward flow of fluids into your abdomen.
Men aged 40 and above may also develop a hydrocele. One of the predisposing factors for the development of a hydrocele in adults is the reopening of channels that allow for a descending of the testicles. Another factor is if the channels did not fully close before birth. Consequently, the open channels allow fluids from the abdomen to move into the scrotum. Another cause of hydrocele is in case of an injury or inflammation in the scrotum. One of the possible causes of such inflammation is an epididymitis infection.
What are the symptoms of hydrocele?
A hydrocele is not painful. The most predominant symptom of a hydrocele is a swollen scrotum. In the case of adult men, the swollen scrotum may feel heavy, and this can be a source of discomfort. As the inflammation increase in size, it is more painful. In some adult males, the swollen area may appear smaller during the morning and it might appear bigger in size by the evening. Sometimes, the scrotum may appear reddish due to the inflammation. Other male adults report feeling pressure at the base of their penis.
The size of a hydrocele may also increase after you have strained or engaged in any form of movement that increases pressure around your abdomen. The pressure may also increase due to coughing or crying. In case of infection due to a hydrocele, you are likely to manifest such symptoms as fever and vomiting. Additionally, you may also develop chills.
Hydrocele rarely affects sexual activities. Nonetheless, certain studies from India have cited adult males as manifesting moderate anxiety symptoms due to hydrocele which in turn adversely impacted their sexual functioning.
How can we diagnose a hydrocele?
To diagnose a hydrocele, your doctor will have to conduct a physical exam of your scrotum. In this case, the scrotum appears larger than usual. By feeling your scrotum, the doctor can ascertain the location of your hydrocele align with the level of swelling.
To conduct the physical exam, the doctor usually shines a light behind each of your testicles. This enables him or her to check for the presence of solid mass due to cancer or other problems on the testicles. Since hydroceles are usually filled with fluid, the moment your doctor shines the light on them, the light goes through. If there is a solid mass, light cannot pass through the testicle.
The doctor is also interested in establishing that your baby is not suffering from another condition, such as hernia. Your doctor may also order a blood or urine test to rule out that the swelling is not as a result of another condition. These tests are useful in terms of ruling out an infection like epididymitis that could mimic similar symptoms to hydrocele.
Another useful test that would allow your doctor to diagnose hydrocele is scrotal ultrasound. The test utilizes sound waves to generate images of male testicles, along with the surrounding tissues. The test enables your doctor to rule out scrotal swelling as a result of testicular tumor, among other causes.
Majority of the hydroceles are not painful. In case of swelling, pain or redness, this could be an indication of filarial relapse. It could also be due to an inflammatory lesion such as epididymitis. For these reasons, it is important that you get a proper diagnosis by a qualified healthcare professional so that you can get treated immediately.
How to treat a hydrocele
If an infant or baby has a hydrocele, treatment is not necessary. This is because the condition often resolves unaided. However, parents and caregivers should form a habit of regularly checking the scrotum. The goal is to identify whether the scrotum has any swelling or if the infant or baby is in pain. You are advised to contact your doctor immediately as soon as these symptoms become apparent. In case you have very large hydroceles, this can cause discomfort. In such a case, the surgical removal of hydrocele remains by far the most effective treatment plan.
During this procedure, your doctor inserts a needle into your scrotum. The goal is to aspirate or remove fluid from the scrotum The procedure can be quite successful especially if the suction drains sufficient quantities of fluid. However, there is a high probability of another hydrocele forming after aspiration. To increase the success of aspiration in the long-term, it may be necessary to inject certain medication alongside the aspiration. This procedure is known as sclerotherapy. Aspiration carries a higher risk of infection in comparison with surgery.
The goal of a hydrocele surgical procedure is to get rid of a hydrocele. In this way, the procedure avoids the recurrence of another hydrocele. In case of large and painful hydrocele in adults, a surgical procedure is highly recommended. The procedure is also the treatment of choice for children aged two years and older.
The procedure takes place under general anesthesia. The surgery is often carried out as an outpatient procedure. The only time when your surgeon may recommend you be retained in a recovery ward is if in case you develop any complications post-surgery. The extent of a hydrocele repair surgery is determined by the presence of other medical problems. In case the hydrocele is not complicated, your surgeon will often make a direct incision into your scrotum. The surgeon proceeds to repair the canal between your scrotum and abdominal cavity if they deem it necessary to do so.
The surgeon then removes the hydrocele sac, followed by draining any fluid from your scrotum. Finally, the surgeon uses sutures to close the incision. For patients who have developed complications, such as inguinal hernia, your surgeon will most likely make an incision in the groin area. In this way, the surgeon gets to also repair the hernia and sort out any other complications. This is done alongside correcting the hydrocele. You do not have to undergo multiple surgeries.
A hydrocele can also be treated using a laser, and this is all due to the advances in medical technology. This is a minimally invasive procedure where the surgeon uses a laser to make a cut on the scrotum. This facilitates the drainage of the fluid that has accumulated in your scrotum. The procedure can be conducted in your surgeon’s office and takes less than 30 minutes. Your surgeon may decide to remove or reverse the sac. Your surgeon will then seal the incision using a laser. The procedure is bloodless and painless, plus you get discharged on the same day. It does not also leave any scar or wound.
Post-op care and diet
Some of the guidelines for post-op care are as follows:
- Get as much rest as you can after hydrocele surgery.
- Avoid overexerting yourself or engaging in strenuous activities, such as lifting heavy objects or jogging. Sufficient rest promotes faster healing. Additionally, engaging in strenuous activities will lead to uneasiness and discomfort. This may hinder your recovery.
- Walk for a few minutes each day. This can promote faster healing.
- Eat light food during the recovery period. However, ensure that the food is balanced and healthy. Greasy and heavy food is not recommended because it might cause constipation. Consequently, you may have a hard time experiencing a smooth bowel movement.
- Increase your intake of foods rich in dietary fiber as this promotes easy and healthy digestion.
- Proper hydration is also important for your recovery. Ensure you remain hydrated by drinking plenty of fluids. If you get dehydrated, the healing process might get impaired, reducing the rate of recovery.
- Avoid wearing tight-fitting clothing as this is likely to irritate your scrotal region. Such irritation may, in turn, cause discomfort and pain.
- Do not engage in any sexual activities until you have fully recovered. If your surgeon has prescribed any medication to relieve pain, make sure to take it as prescribed.
- In case you develop any complications while at home, we encourage you to get in touch with your surgeon as soon as possible.
A hydrocele is a condition in which your scrotum gets filled with fluid. A hydrocele is rarely painful, but it can cause discomfort, especially when it gets bigger in size. Also, a hydrocele can interfere with your daily activities such as sexual activity and walking. Examples of home remedies in managing hydroceles include Epsom salt bath and herbal paste. However, such remedies rarely work. It is important, therefore, that you get proper treatment for the condition, such as a surgical procedure.
Our team of surgeons at goficure is experienced in treating hydrocele across Bangalore. We highly recommend laser surgery for the removal of hydroceles, as this procedure is faster, less invasive, and has a reduced risk for infection compared with conventional surgery.
Some of the benefits of associating with goficure for hydrocele treatment are as follows:
We have some of the most advanced equipment in Bangalore for treating hydroceles.
We offer highly discounted consultation services that give you access to the most experienced surgeons in Bangalore in treating hydroceles.
We will make arrangements to get you picked up from your home in readiness for the procedure, assist you in filling all the paperwork, and making an insurance claim. We also liaise with other specialty facilities in Bangalore so that you receive timely and proper care. Our post-op services are second to none in Bangalore. You will receive timely advice from nutritionists on the diet plans that suits you best. We will also keep in touch with you to establish that you are recovering well. Our team of experts will offer you useful tips on the dos and don’ts to promote quick recovery and minimize the risk of recurrence.
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
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