Swollen testicles (hydrocele)

Condition

Hydrocele is a condition where fluid accumulates around the testicle, causing swelling. The fluid is secreted by the sac surrounding the testicle, and sometimes there is an imbalance between production and reabsorption of this fluid, resulting in gradual accumulation of fluid and swelling of the scrotum on that side. This can occur slowly over many years.

Swellings around the testicles are not cancer. They can cause pain, discomfort, limit activity, or make a man feel insecure. It is not recommended that they are drained because they recur. This condition is best treated by surgery to remove them, if required. 

Treatment

This operation is performed to remove excess fluid around the testicle.

Patients usually have an ultrasound scan before surgery to check that the testicle is normal and that there are no other findings other than a simple hydrocele.

The operation is performed under general anaesthetic through a midline cut in the scrotum.  The bag around the scrotum is opened up and the excess fluid is drained away and as much of the bag as possible is removed to prevent the fluid returning.  The testis is then returned to the scrotum and the wound closed and local anaesthetic applied.

The operation is very safe but some risks include bleeding, infection (5%), pain in the wound for a few days and in 5-10% of men the fluid can recur in the following years. The patient can usually be discharged on the same day and can be followed up by the GP or seen again in 6 weeks for review.  Patients should wear supportive underwear for one week and avoid strenuous activity for 1-2 weeks. Driving is allowed once the patient feels comfortable.