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Hydrocele Surgery (Hydrocelectomy)

Side view of scrotum showing hydrocele formed around testicle.

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.

Preparing for surgery

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

  • Tell your doctor about all medicines you take. This includes both prescription and over-the-counter medicines. This also includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery as instructed by your doctor.

  • Follow any directions you are given for not eating or drinking before surgery.

The day of surgery

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

Before the surgery starts

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

  • You are then given medicine (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 put into your throat to help you breathe.

  • Local anesthesia or numbing medicine 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 or surgical strips.

After the surgery

You will be taken to a room to recover from the anesthesia. A nurse will monitor you and 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 put on 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:

  • Apply an ice pack or cold compress to the scrotum as directed to help reduce swelling. 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 medicine 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 OK.

  • Wear a jockstrap or snug underwear as directed.

  • Don't lift anything heavy. Exercise as directed.

  • Don't have sex for 4 weeks, or as directed.

  • Don't drive until you are no longer taking pain medicine and your doctor says it’s OK.

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

  • Chest pain or trouble breathing (call 911)

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • 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 medicine

  • Increased pain or swelling in the scrotum or groin area

Follow-up care

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

Risks and possible complications

  • 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. 

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