A hydrocele is a collection of fluid within a man's scrotum - which is basically a reservoir of fluid around one or both testicles. This is a fairly common condition, and affects about 1 to 2% of boys. In the vast majority of cases, hydrocele causes no symptoms and tends to go away on its own, without treatment. Stubborn hydroceles usually require surgery, although you can also use some home remedies.
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Part 1 of 2: Understanding and Handling Hydrocele
Step 1. Recognize the signs and symptoms
The first indication of a hydrocele is swelling or enlargement of the scrotum but not pain. The swelling indicates a collection of fluid around one or both testicles. Hydroceles that occur in infants rarely cause complications and will usually disappear without treatment before the child is one year old. On the other hand, an adult male with a hydrocele may feel discomfort when the scrotum swells and gains weight. In extreme cases, this can make it difficult for the sufferer to sit or walk/run.
- The pain or discomfort caused by a hydrocele is usually related to its size. The bigger the size, the more uncomfortable it will be.
- Hydroceles tend to be smaller in the morning (after waking up), and get bigger as the day progresses.
- Premature babies have a greater risk of developing a hydrocele.
Step 2. Be patient when experiencing a hydrocele
In most cases in baby boys, adolescents and adult men, hydrocele can go away on its own without special treatment. Blockages that occur near the testicles will go away on their own, and the hydrocele will dry up and be absorbed into the body. Therefore, if your scrotum is enlarged and doesn't hurt or is causing problems with sex or urination, allow some time for the swelling to go away on its own.
- For baby boys, hydrocele usually goes away on its own within a year after birth.
- Depending on the cause, hydroceles that occur in adult men will often go away gradually over six months. Large hydroceles can take longer, but not more than a year if not treated.
- Hydroceles in children and adolescents can be caused by infection, trauma, torsion or testicular tumors, so the condition should be confirmed by a doctor first.
- A hydrocele is similar to a ganglion (nerve node) that forms inside a tendon sheath near a joint that will gradually disappear.
Step 3. Try bathing with Epsom salts
If your testicles/scrotum are swollen but not painful, try taking a warm bath mixed with a few cups of Epsom salts. Relax in the tub for 15 to 20 minutes with your legs slightly apart, so that your scrotum is submerged in the water. The warmth of the water stimulates the movement of body fluids (which can help open blockages) and the salt content can expel fluids through the skin and reduce swelling. Epsom salt is also high in magnesium, which can help relax muscles/tendons and relieve pain.
- If your hydrocele is painful, soaking your scrotum in warm water (or another heat source) can increase the swelling and make symptoms worse.
- Don't shower in too hot water (so you don't scald) and don't stay in the tub for too long (so you don't get dehydrated).
Step 4. Don't let your testicles get injured or get STDs (sexually transmitted diseases)
The cause of hydrocele in male babies is not known, although it is thought to be due to fluid reserves that occur due to poor circulation while the baby is still in the womb. However, for older boys and men, it is usually due to an injury to the scrotum or an infection. Wounds can be obtained when playing wrestling, self-defense, cycling, and various sexual activities. Infections that occur in the testes / scrotum are often associated with sexually transmitted diseases. Therefore, protect your scrotum from getting hurt and practice safe sex.
- If you play a sport that is prone to impact, always wear protective gear made of plastic to protect your scrotum from injury.
- Always use a new condom when you have sex to reduce your risk of getting an infection. STDs don't always affect the testicles, but it's not impossible.
Step 5. Know when you should get medical help
Seek medical help for your baby boy if the scrotal swelling doesn't go away after a year, or it keeps getting bigger. Go to the doctor immediately if the hydrocele in adult men does not go away for more than 6 months, or if the large size of the hydrocele causes pain / discomfort or disability.
- A hydrocele is not the same as a testicular infection, but a testicular infection can cause a hydrocele. Testicular infections are very painful and must be treated because they can increase the risk of infertility. Hydrocele has no impact on fertility.
- Go to the doctor immediately if the hydrocele has interfered with your running, walking, or sitting activities.
- Hydrocele has no effect on fertility
Part 2 of 2: Seeking Medical Treatment
Step 1. Go to the doctor for a checkup
If the hydrocele doesn't go away for longer than usual or is causing pain and other symptoms, see your doctor for a check-up. Hydrocele is not a serious condition, but your doctor will rule out some conditions that look similar, for example: inguinal hernia, varicocele, infection, benign tumor or testicular cancer. Once the hydrocele diagnosis has been made, the only best option is surgery. Treatment will not be effective.
- Maybe the doctor will use an ultrasound, MRI or CT scan to get a clearer visualization of the scrotum.
- Shining a bright light into the scrotum will show whether the fluid is clear (indicating it is a hydrocele) or cloudy, which could indicate the presence of blood and/or pus.
- A useful way to rule out infections such as epididymitis, mumps or various sexually transmitted diseases is to have blood and urine tests.
Step 2. Drain the liquid
Once diagnosed with a hydrocele, one of the simplest procedures is to drain the fluid using a needle, which is called aspiration. After administration of topical anesthetic, a needle is inserted into the scrotum to penetrate the hydrocele and suck out the clear fluid that is inside. If the fluid contains blood and/or pus, this indicates an injury, infection or possibly cancer. The procedure is performed very quickly and does not require a long recovery time - usually about a day or two.
- Suction of fluid using a needle is not done too often because the fluid will collect back, thus requiring further treatment.
- Sometimes the needle must be inserted through the inguinal (groin) area if the hydrocele has formed too high in the scrotum or is partially outside the scrotum.
Step 3. Perform surgery to remove the entire hydrocele
The most common and most effective way to treat a persistent and symptomatic hydrocele is to remove the hydrocele pocket along with the fluid. This procedure is called a hydrocelectomy. In this way, the probability of the hydrocele growing back is only about 1%. This surgery can be performed with a scalpel or laparoscopically, which is a procedure by attaching a camera to a long surgical instrument. Hydrocele surgery is usually performed under general anesthesia but the patient does not need to stay overnight. The healing process can take a week or more, depending on whether the abdominal wall was cut or not.
- In infants, the surgeon will usually slice through the groin (inguinal area) to drain the fluid and remove the pouch. Then stitches will be given to strengthen the muscle wall. It's basically the same as hernia surgery.
- In adults, the surgeon will usually slice through the scrotum to remove fluid and remove the hydrocele sac.
- After a hydrocelectomy, your scrotum may have a tube inserted for a few days to drain excess fluid.
- Depending on the type of hydrocele, surgical repair may be recommended to reduce the risk of herniating into areas not getting blood supply.
Step 4. Don't be too tense when you're recovering
In most cases, recovery from hydrocele surgery will be relatively fast. Healthy adult men are usually able to go home a few hours after undergoing surgery - rarely a hospital stay. Children's activities should be limited (no rough play) and longer sleep or rest for about 48 hours or more after surgery. Adult men should also follow the same advice, and delay sexual activity for up to a week to avoid unwanted things.
- For most patients who have recently undergone hydrocele surgery, normal activities can be resumed after 4 to 7 days.
- Some of the possible complications that can occur after undergoing surgery include: allergic reactions to anesthetics (due to breathing problems), persistent bleeding inside or outside the scrotum, and infection.
- Signs of a bacterial infection include pain in the groin, inflammation, redness, a foul odor and possibly a low-grade fever.
Tips
- Don't be shy about examining your own scrotum from time to time. This is a great way to detect problems (such as hydrocele) before they develop into a more serious condition.
- Although rare, a hydrocele can form due to infection with filarial (parasitic) worms in the testicles which can cause severe swelling and elephantiasis.
- To reduce discomfort after a hydrocelectomy, it is recommended that you use a scrotal support strap and use crushed ice (wrapped in cheesecloth) to help reduce swelling.
- Sometimes a hydrocele occurs at the same time as an inguinal hernia, although usually one operation can treat both conditions at once.
