What is a hydrocele?
Hydroceles usually appear after a hernia has formed. During fetal development, the testicles move down from the abdomen into the scrotum through an open tube or channel. This channel closes before birth. If the channel is still open after birth, the child may develop a hernia and thereafter a hydrocele.
A hernia forms when the channel is large enough for a part of the intestine to pass through. Fluid from the abdominal cavity can then enter the channel if it is open. This fluid enters the testicle and surrounds the scrotum, resulting in the formation of a hydrocele.
A fluid-filled sac that develops often first noticed as swelling around a testicle is a hydrocele. When fluid from the surrounding tissue escapes into the scrotum, hydroceles develop. The sac could be tiny and not cause any symptoms, or it could become bigger and cause swelling in the scrotum.
Even while a hydrocele rarely hurts, it can be uncomfortable. When the testicle shifts, the sac may make the scrotum feel heavier than usual or hurt. Both testicles and one of them may experience hydroceles.
How common is a hydrocele?
Hydroceles are quite common in newborn boys, and they can grow to be very large. The size of a hydrocele can change as fluid goes in and out of them. Fortunately, hydroceles do not cause injury to the testicles. Since the open channel is usually narrower with a hydrocele than with a hernia, it may close off by itself before the child is a year old. After it closes, the fluid in the scrotum will gradually disappear.
Who gets a hydrocele?
Males develop hydrocele at any age, but it is most prevalent in newborns and older men. When a hydrocele develops in older men, it is usually because of injury or damage.
What are the signs and symptoms?
A hernia can cause a bulge in the groin area that you may see when your child coughs, strains or cries. That bulge may disappear on its own or when you apply gentle pressure to it. If the bulge does not disappear,
you should take your child to the doctor immediately. If a portion of the intestine gets stuck in a hernia channel, your child may become feverish or fussy and may start vomiting.
If your child has a hydrocele without any other issues, the scrotum on the side of the hydrocele will be enlarged and may appear bluish. Hydroceles do not cause any bulges in the groin area, and your child
may not experience any symptoms.
How is a hydrocele diagnosed?
Your doctor can examine your child and determine if they have a hydrocele. It may be necessary to have an ultrasound to help with the diagnosis. The ultrasound works by shining a light through the scrotum thus making it easier to detect a hydrocele.
Observation-wise, the scrotum on the side of the hydrocele will be swollen and may seem bluish if your child only has a hydrocele. Often, the fluid surrounding the testicle often prevents the testicle from being felt.
Your child might not exhibit any symptoms, as hydroceles do not result in groin bulges, but call the doctor right away if your son's scrotum becomes enlarged or if they are clearly uncomfortable and hurting.
When is surgery needed?
A hydrocelectomy is only necessary in extreme cases. Over several months, as the body absorbs the fluid, most hydroceles resolve on their own.
Doctors advise delaying hydrocelectomy for most children with hydroceles until they are about 12 months old to see whether the hydrocele will go away on its own. In most cases hydroceles are painless and harmless, but large hydroceles can be uncomfortable, and surgery may be required to drain the fluid.
For instance, after a year, if the hydrocele is still there, we will operate; a small incision in the groin will be made, and the surgeon will drain the fluid from the sac before removing the tube or channel that connects the abdominal cavity to the scrotum.
We might advise surgery sooner if the hydrocele is quite large, if it keeps contracting and expanding after six months, or if there is a hernia present.
What can I expect from surgery?
Since hydrocele repairs are performed as outpatient procedures, your child won't need to spend the night in the hospital. Such operations are completed in an hour or less.
On the day of surgery, you will meet with both the surgeon and the anesthesiologist prior to the operation. During surgery, dissolvable stitches will be used under the skin by the surgeon. After surgery, the dressing used to keep the incision clean and free of infection will naturally come off.
Teenage boys experience adult-type hydroceles caused by other issues such as infection, torsion (testicular twisting), or a tumor. For teenage boys with adult-type hydroceles the surgical treatment is contrary to that of a child with hydroceles. A scrotum incision and gauze bandages are often used to cover the surgery region for a few days in teenage boys with adult-type hydroceles.
Even though there usually isn't much discomfort following hydrocelectomy, your child may require a prescription for pain medication from a doctor, such as simple Tylenol or Tylenol with codeine every 4 to 6 hours for pain. The medications are given at first when your child is in the recovery room.
The majority of children are discharged from the hospital on the same day as their operation. Some, however, are admitted to the hospital for observation. Your child will be in the recovery room following surgery until they are ready to go home. Parents are welcome to give their children company in the recovery room until they are cleared to go home by the doctor.
After a hydrocelectomy, make sure your child rests for at least three weeks and avoids physical activity such as using straddle toys or bicycles, participating in sports, or going to a gym class. Your child should refrain from bathing for at least five days. Your child may take a sponge bath at home, but they should avoid taking a tub bath or swimming.
Depending on how they feel, many children are cleared to return to school within 2 to 3 days of surgery. However, it is advisable for the parent to schedule a two-week follow-up appointment with their child’s doctor on the day following the surgery for the doctor to check how the area is healing.