Whenever you notice any swelling over your scrotum, you think you have developed hydrocele and you start thinking about what could be hydrocele treatment and  what could be hydrocele surgery . But that could not be true every time. There are many diseases where your scrotum can develop a swelling which can mimic hydrocele. Hence you should know what is hydrocele exactly. Also so you must understand the difference between hydrocele and hernia.

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What is hydrocele and what is hydrocele surgery?

The simple meaning of hydrocele is the collection of some fluid around your testes. Hydrocele could be unilateral or bilateral. Hydrocele doesn’t need to be always bilateral. And hydrocele surgery is the opening of the whole sac of the hydrocele and reversing it so that there should not be any collection in future.

What are hydrocele causes?

Now the question arises why there is a collection happening around your testis. The exact cause of the development of fluid around the testes is not known scientifically. But it could be excess production of the fluid which normally present around the testis.

On another hand, it could be because of a lack of absorption of the fluid around testis which usually exists to prevent such collection of hydrocele. Whenever any of these mechanisms failed, collection of fluid occurs around the testis and hydrocele develops.

Some other diseases which can lead to hydrocele are filaria of the scrotum, generalised oedema of the body, kidney failure, cancer of testis, infection of the scrotum, and gangrene of the scrotum, cancer of the penis, etc.

What should you do for hydrocele treatment?

Whenever you notice any swelling around your testes, you must consult a general Surgeon to get it properly checked for hydrocele treatment. Because there could be a possibility of any disease which can lead to hydrocele. This Means hydrocele could not be always a simple collection of fluid.

If you failed to check up with a proper doctor, then you will neglect the things for years and later on, you may come to know that it is not a simple hydrocele but it is a hernia or it is testis cancer.

And this type of incident happened in my practices many times. The patient came to me for the treatment of hydrocele and later on we came to know after a thorough examination that the patient has testicular cancer which is now beyond the treatment. So to avoid this you must check your testis from the doctor.

Best doctor for the hydrocele surgery

When you search for the best doctor for hydrocele in Google search, you may come across many doctors over the internet who will misguide you that they have medicine for the hydrocele and there is no need for surgery. They advertise hydrocele treatment without surgery.

Some doctors can claim that they will only aspirate out all the fluid from the hydrocele and there will be no requirement for surgery for it.

All these advertisers will miss guide you and you may land up in a horrible situation if you are willing to go to these doctors.

Then where to go for a proper examination. 

All allopathic surgeons which are practising laparoscopy surgery are general surgeons, and the best choice to get your testes examined. They are a proper specialist doctor for your testicular diseases.

If you want again super specialist of testicular pathology then you can go to uro-surgeons available in your city. But uro surgeon will price you more than any laparoscopic or General Surgeon. Better you look for a coloproctologist in your city.

Examination of testis for hydrocele treatment.

The doctor will examine you in a lying down position over the examination table with proper light. He will first check whether your spelling is exactly hydrocele or it is Hernia. With proper examination, he can better differentiate these two pathologies. Then he will look for the nature of the collection inside the hydrocele. There are many clinical tests which he will perform to know the content of the fluid.

Only by clinical examination, he can conclude that you have a simple hydrocele or infected hydrocele or any testicular Pathology. After examination, he will order some investigation for the confirmation of his diagnosis and further management purpose.

Investigations are ultrasound of the scrotum with colour Doppler, Ultrasound of the inguinal canal to rule out any hernia. And some blood and urine investigations.

What is the treatment for hydrocele, hydrocele surgery?

In general, in our society people consider hydrocele as a simple surgery and any type of doctor can do it. Even they think that local treatment offered by some uneducated doctors can also treat hydrocele very well.

 Because of all these misbeliefs, people don’t consider hydrocele as a serious disease and sometimes land up in complicated situations because of wrong treatment or surgery.

What is the treatment which can lead to some complications?

1. # Aspiration of hydrocele fluid.
2. # Aspiration of hydrocele fluid and injection of a sclerosing agent.
3. # Application of some herbal paste over the scrotum.
4. # Giving medicine for long time for treatment of hydrocele considering it could be due to Filaria.

These are the same treatment modalities offered by some untrained individuals. As these people advertise their practices to attract patients, they get many numbers of patients who are actually afraid of surgery and who you are unable to pay a huge amount of surgical costs.

But all people are trying to save their money for the treatment of hydrocele, at last, they end up spending a huge amount for no benefit.

 Hence you must provide all these things and don’t allow any such individual who is not a doctor or properly trained doctor for the purpose of hydrocele Management.

What is hydrocele surgery?

Please keep in mind that hydrocele is curable by hydrocele surgery only. Many others are some people also claim that it could be curable by some Ayurvedic, homoeopathy or wild herbs, but this is all false.

Then what exactly do surgeons do in hydrocele surgery?

In hydrocele surgery, the surgeon opens the scrotum and hydrocele cyst, drained its fluid outside, and inverts the sac posterior to the testes so that no more collection will be there in front of the testis. The name of the surgery itself is the eversion of the sac. This makes a 100% cure in case of hydrocele.

Although it looks to be simple to read, many times it may be difficult by an experienced hand.

Complications of hydrocele

1. # Hematoma formation
2. # Testicular torsion
3. # pus formation
4. # Gangrene of scrotum
5. # Infertility in male
6. # Loss of libido

These are some complications of hydrocele if it is not operated on in a lifetime.

Hematoma formation

Hematoma means a collection of blood in hydrocele fluid. This happens when you do not get operated on for hydrocele and sometimes you get trauma to your scrotum by trivial injury or falling down. These breakups some vessels of the cyst and its bleeding collected within hydrocele fluid which leads to the formation of Hematoma.

 This hematoma may be very painful. Because of the pain many times it needs emergency surgery to drain all the collected blood inside the hydrocele cavity.

Testicular torsion

Although it is not a common complication of hydrocele, it may happen sometimes. Usually, it happens in small-size hydroceles. Twisting of testing more than 180 degrees within hydrocele, can lead to ischemia of the testis. This is a dire emergency because if it is not retwisted within the time limit, it can lead to gangrene of the testes. And if gangrene happens, it will not be reversible. The patient may land up in the removal of one of his testis.

Pus formation (pyocele formation)

Also known as pyocoele of scrotum. It is nothing but the formation of pus inside hydrocele fluid. The hydrocele itself can transform into pus formation due to endogenous bacteria. This is more common in Diabetic and immunocompromised patients.

The pus formation could happen due to aspiration of hydrocele fluid without following safety precautions. This is practised by many town doctors.

This pus formation can also be due to the formation of Hematoma. Later hematoma gets easily infected and pus develops.

Gangrene of scrotum ( Fourniers gangrene)

Gangrene of the scrotum means blackening of the scrotal skin. This is also a rare phenomenon but happens once in a while. Because in some individuals blood supply of the scrotum is not well developed. This means blood-supplying arteries are end arteries running over the scrotal skin. And wherever there is an infection of the scrotum these arteries get blocked due to infection and ischemia of the scrotum develops.

This is also a life-threatening emergency. Because this gangrene can lead to the development of generalized septicemia and the patient may land up in shock which could be fatal.

Infertility in male

Infertility secondary to hydrocele is not uncommon in India. It could be associated with the development of varicocele. Varicocele is a condition where spermatic cord veins get dilated due to blockage at a higher level.

Due to the formation of a hydrocele around the testes, the sperm formation of the testes was hampered as the required temperature could not be maintained due to fluid around the testis.

Whenever there is a patient with male infertility and hydrocele, we always suggest getting operated for hydrocele. 50% of cases get a good result and achieve a very good sperm count after surgery.

Loss of libido

Loss of libido means a decreased desire for sexual contact with the partner. This may be due to a feeling of shame to show a private part with an enlarged scrotum. In the later stage when the hydrocele develops to attend large size, in that situation the shaft of the penis is buried in the size of the hydrocele. That also affects the sexual relationship with the partner.

Frequently asked questions

1) Can we treat both sides of the hydrocele in a single sitting?

Ans: yes, it is possible. Many times we do it in a single sitting. This avoids the expense of surgery on the other side of hydrocele in future.

2) Do hydrocele transform into cancer?

No, hydrocele will never transform into cancer or not testis is going to be cancerous in future. But sometimes testicular cancer itself can develop into hydrocele. This type of hydrocele cannot be cured by simple surgery as the fluid collection is because of malignancy.

3) Is hydrocele always associated with a hernia?

It is true that hydrocele is sometimes associated with hernia but it does not always occur. Whenever there is a Hernia with hydrocele, both diseases require different surgery in the same sitting.

4) Can we operate hydrocele in old-age patients?

Yes, we can operate on hydrocele at any age unless the person has comorbid conditions which could lead to life-threatening complications if we submit him for surgery. In such cases, we compare the benefits and drawbacks of surgery.

5) Can we get operate at an Ayurvedic hospital?

You can do this type of surgery at an Ayurvedic multispeciality hospital also where Ayurvedic General Surgeon can operate this surgery. But one thing you have to see is whether that surgeon is well experienced to do such type of surgery or not because with an inexperienced hand, this simple surgery can lead to any type of complication.

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