Hydrocele Surgery (Hydrocelectomy)

A hydrocele is a sac of fluid that forms around a testicle. It occurs when fluid builds up in the layer of tissue that covers the testicle. It may be caused by an infection or by injury to the testicle. But the cause is often not known. A large hydrocele can cause pain or swelling in the scrotum. Hydrocelectomy is surgery to remove the hydrocele. This sheet explains the procedure and what to expect.

Side view of scrotum showing hydrocele formed around testicle.

Preparing for Surgery

Prepare for the surgery as you have been told. In addition:

  • Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as Coumadin, Plavix, or daily aspirin. You may need to stop taking some or all of them before surgery.

  • Do not eat or drink during the 8 hours before your surgery. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)

The Day of Surgery

The procedure takes about 30 minutes. You will likely go home on the same day.

Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This line delivers fluids and medications (such as antibiotics).

  • You are then given medication (anesthesia) to keep you free of pain during the surgery. This may be general anesthesia, which puts you in a state like deep sleep through the surgery. A tube may be inserted into your throat to help you breathe.

  • Local anesthesia or numbing medication may be given to help control post-surgery pain. The doctor or anesthesiologist can tell you more.

During the surgery:

  • An incision is made in the scrotum.

  • The hydrocele is drained of fluid. The tissue that forms the sac around the hydrocele is removed or repositioned. This helps prevent fluid from building up again.

  • A thin tube (drain) may be placed in the incision to allow fluid to drain.

  • The incision in the scrotum is closed with stitches (sutures) or surgical strips.

After the Surgery

You will be taken to a room to recover from the anesthesia. A nurse will check on you to make sure you’re not in pain. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. An ice pack may be applied to the surgical area. This helps reduce swelling. You may also be given a jockstrap to wear. This helps relieve pain and swelling, and prevents injury. Once you are ready to go home, have an adult family member or friend drive you.

Recovering at Home

Follow the instructions you have been given to care for yourself. During your recovery:

  • To help reduce swelling, apply an ice pack or cold compress to the scrotum as directed. Do this for no longer than 15 minutes at a time. Continue using the cold pack for 2 days or until swelling improves.

  • Take prescribed pain medications as directed.

  • Care for your incision as instructed.

  • Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incision to be covered with water until your doctor says it’s okay.

  • Wear a jockstrap or snug underwear as directed.

  • Avoid heavy lifting and strenuous exercise as directed.

  • Do not have sex for 4 weeks.

  • Do not drive until you are no longer taking pain medication and your doctor says it’s okay.

Call the Doctor If You Have Any of the Following:

  • Chest pain or trouble breathing (call 911)

  • Fever of 100.4°F or higher

  • Symptoms of infection at the incision site such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Bleeding from the incision site

  • Pain gets worse or is not relieved by pain medications

  • Increased pain or swelling in the scrotum or groin area

Follow-Up

You will have follow-up visits with your doctor to check on your healing. You may also have sutures that need to be removed. Be sure to tell your doctor if you have any questions or concerns about your recovery.

Risks and Possible Complications Include:

  • Bleeding

  • Infection

  • Blood clots

  • Recurrence of the hydrocele

  • Injury to the testicle and nearby structures, which can lead to infertility

  • Risks of anesthesia (the anesthesiologist will discuss these with you)