Hydrocele Treatment in Indore

A hydrocele is a collection of fluid around the testis, producing a soft, painless swelling of the scrotum. It is one of the most common scrotal conditions in adult men and is entirely benign in the great majority of cases. The importance of a proper examination lies not in the hydrocele itself but in confirming that the swelling is a hydrocele and not a hernia, a tumour or an infection.

What is a Hydrocele?

The testis is wrapped in a two-layered membrane called the tunica vaginalis. A small amount of fluid normally lubricates the space between these layers. When production exceeds absorption, or when the passage from the abdomen fails to close in infancy, fluid accumulates and the scrotum enlarges. A hydrocele transilluminates, meaning a torch held against the scrotum lights it up, which is a simple bedside way of distinguishing it from solid swellings.

Causes of Hydrocele

1. Primary or idiopathic: No identifiable cause, the commonest situation in adults over 40.
2. Congenital: A patent processus vaginalis in infants, which often closes on its own in the first year.
3. Infection: Epididymo-orchitis, tuberculosis and filariasis, which remains relevant in parts of India.
4. Trauma: Injury to the scrotum causing a reactive collection.
5. Tumour: A testicular tumour can present with a secondary hydrocele, which is precisely why every new scrotal swelling is examined and scanned.
6. Post-surgical: After hernia repair or varicocele surgery.

Symptoms of Hydrocele

1. A painless, gradually enlarging scrotal swelling, usually on one side
2. A feeling of heaviness or dragging, worse at the end of the day
3. Difficulty walking, sitting comfortably or wearing fitted clothing when large
4. Embarrassment and interference with sexual activity in large hydroceles
5. Pain, redness and fever only if infection is present

When to See a Doctor

See a surgeon for any new scrotal swelling. Seek urgent care if the swelling is painful, appears suddenly, is associated with fever, or if the testis becomes hard or irregular. Infant hydroceles that persist beyond 12 to 18 months, or that change in size through the day (suggesting a communicating hydrocele or hernia), should be assessed.

Treatment for Hydrocele

1. Observation: Small, symptomless hydroceles in adults and most infant hydroceles under a year need no intervention.
2. Scrotal ultrasound: Confirms the diagnosis and, importantly, examines the underlying testis before any surgery.
3. Hydrocelectomy: The definitive treatment. The sac is opened, the fluid drained and the sac either everted (Jaboulay) or excised, in a short daycare operation under spinal or local anaesthesia.
4. Aspiration with sclerotherapy: Reserved for men unfit for surgery, as the recurrence rate is high.
5. Treat the cause: Antibiotics for infection, antifilarial therapy where indicated, and hernia repair if a communicating defect is found.

What Happens If You Delay Treatment

A hydrocele left alone tends to grow slowly and steadily. Very large hydroceles stretch the scrotal skin, make walking and sitting uncomfortable, interfere with intercourse and become technically harder to repair with a longer recovery. Long-standing hydroceles can also compress the testis and impair its blood supply and function. Most importantly, a swelling that is assumed to be a simple hydrocele but never examined can be concealing a testicular tumour, and testicular cancer is highly curable when caught early. One ultrasound removes that doubt.