Hydrocele
A hydrocele (water hernia) is a swelling in the scrotum caused by the accumulation of fluid around the testicle. It can occur around one or both testicles. A hydrocele may be communicating if there is a channel in the inguinal canal connecting the water hernia to the abdominal cavity, or it may be non-communicating. In children, a communicating hydrocele is more common and can change in size throughout the day depending on the child’s activity, while a non-communicating hydrocele remains the same size regardless of activity and does not change over time. Hydrocele does not cause pain and does not affect the development or function of the testicle.
Why does hydrocele occur?
Towards the end of pregnancy, the testicles descend into the scrotum through the inguinal canal, accompanied by a pouch-like extension of the peritoneum. If this pouch does not fully close after birth, a hydrocele may develop. Fluid from inside the abdomen can then pass between the abdomen and the scrotum through this narrow channel, causing swelling in the scrotum.
In most cases, the pouch closes spontaneously during the first years of life, and the hydrocele disappears, eliminating the need for surgical treatment.
What are the benefits of surgical repair of hydrocele?
When a hydrocele does not resolve spontaneously, surgery is indicated. Occasional fluid accumulation in the scrotum can cause pain and discomfort, particularly during physical activity. Current scientific evidence suggests that hydrocele does not affect the development or function of the testicles.
How is hydrocele treated surgically in children?
Hydrocele surgery is performed under general anesthesia. The surgeon will make a small incision in the groin area to locate and close the abdominal sac in the inguinal canal. The incision site on the skin is then closed with absorbable sutures, which will dissolve naturally during the healing process.
Hydrocele can also be treated using minimally invasive surgery, such as laparoscopic surgery. In this case, your child will receive a small incision through the belly button and two smaller incisions on either side of the abdomen below the belly button. The peritoneal sac in the inguinal canal area will be closed using laparoscopic instruments.
Ako Vaše dijete ima hidrokele obostrano, obje strane se mogu operirati istovremeno.
Are there other treatment options for hydrocele besides surgery?
Surgery is the only treatment option for a hydrocele that has not closed spontaneously.
What are the possible complications of hydrocele surgery?
The complications of this surgery are rare, but they may include:
- Swelling and bleeding from the incision site and in the scrotum.
- Infection of the wound: If the wound becomes red, painful, or discharges pus, contact your child's general practitioner or surgeon who may prescribe antimicrobial treatment.
- Recurrence of the hydrocele, which would require another surgery.
- Injury to the spermatic cord: This should not affect your child's growth or reproductive function if the contralateral spermatic cord is functional.
- Injury to the blood vessels of the testis: This will reduce blood flow to the testis, potentially causing shrinkage (atrophy) of the testis. This should not affect your child's growth or reproductive function if the contralateral testis is functioning properly.
- Retraction of the testis into the inguinal canal (scar tissue at the surgical site pulls the testis towards the groin): This will require another operation.
- In laparoscopic surgery, there is a risk of injuring intra-abdominal organs such as the intestines or bladder. These injuries are detected during the surgery and can be repaired immediately.
The surgeon will discuss the possible complications and their management with you in more detail.
