Hydrocele is a buildup of fluid inside the scrotum - basically it's a collection of fluid around one or both testicles. This is a relatively common disorder (it is estimated that 1-2% of US boys are born with a hydrocele). In most cases it does not cause any symptoms and tends to resolve on its own without any treatment; However, to cure a persistent one, surgery is required, although home remedies can help.
Steps
Part 1 of 2: Knowing and Managing Hydrocele
Step 1. Recognize the signs and symptoms
The first indicator of hydrocele is a painless swelling or dilation of the scrotum caused by fluid accumulating around one or both testicles. Infants rarely suffer from complications from this disorder and in most cases the hydrocele disappears by the age of one without any treatment. Conversely, when the bulge develops in adulthood, men experience discomfort as the scrotum swells and becomes heavy. In really extreme cases they may have difficulty sitting or walking and running.
- Pain and discomfort are typically related to the size of the hydrocele; the larger it is, the more likely you are to perceive it.
- Swelling is reduced in the morning, as soon as you wake up, but tends to increase over the course of the day.
- Premature babies are at an increased risk for hydrocele.
Step 2. Be patient
In the vast majority of cases (regardless of whether the subject is a newborn, adolescent, or adult man), the hydrocele disappears on its own without specific treatment. Obstruction or congestion near the testicle clears up on its own and fluid buildup is drained or reabsorbed by the body. For these reasons, if you notice a lump in your scrotum that doesn't cause pain and doesn't make sexual intercourse and urination particularly complicated, then give your body some time to heal on its own.
- In infants, hydrocele typically disappears spontaneously by one year of age.
- In adults, on the other hand, the swelling gradually decreases over 6 months, depending on the triggering cause. Larger hydroceles take longer, but shouldn't take more than a year, without medical intervention.
- However, hydroceles in children and adolescents can be caused by infection, trauma, testicular torsion or tumor, so these causes must be ruled out by a doctor.
- These sacs are similar to fluid-filled cysts that form on the tendon sheaths near the joints and then gradually disappear.
Step 3. Try taking a bath with Epsom salts
If you notice a painless swelling in one or both testicles or scrotum, try taking a very hot bath with at least 300g of Epsom salts. Relax in the tub for 15-20 minutes with your legs slightly spread so that the water reaches the scrotum. The heat stimulates the movement of body fluids (and may also unblock the occlusion that causes the hydrocele), while the salt draws fluids from the skin and reduces swelling. Epsom salts are rich in magnesium, which is able to relax muscles, tendons and soothe pain.
- If hydrocele causes you pain, be aware that exposing the scrotum to hot water (or any other source of heat) could worsen inflammation and aggravate symptoms.
- Do not take a hot bath (to avoid burns) and do not soak for too long (to avoid dehydration).
Step 4. Do not expose yourself to sexually transmitted diseases and protect your testicles from trauma
The cause of hydrocele in newborns is still unknown; however, it is thought to be a stagnation of fluids caused by poor circulation, which in turn is generated by the position of the fetus in the womb. In adults and adolescents, trauma to the scrotum or infection is usually the cause. During the practice of sports such as martial arts, wrestling, cycling or during the sexual act an accident can always happen, so the scrotum can be subjected to some trauma. Testicular infections are often related to STDs. For these reasons, protect your scrotum from bumps and practice safe sex.
- If you play contact sports, always wear a jockstrap with a plastic shell to protect your testicles from injury.
- Always use a new condom when having sex to drastically reduce the risk of infections. A sexually transmitted disease does not always affect the testicles, but it is not such a rare event.
Step 5. Know when to seek medical help
You should see your pediatrician if the swelling on your newborn baby's scrotum does not go away within the year or if it grows. Men should see an andrologist if the hydrocele persists for more than 6 months or becomes large enough to cause pain, discomfort, or deformity.
- A testicular infection isn't the same as a hydrocele, but it could cause one. Testicular infections are very painful and must be treated, as they put a man's fertility at risk. Always seek medical advice for scrotal pain and fever.
- You should also go to the doctor if the swelling is preventing you from running, walking, or sitting normally.
- Hydrocele does not interfere with the ability to have children.
Part 2 of 2: Seeking Medical Care
Step 1. Go to the doctor for an examination
If the hydrocele persists for longer than normal or causes pain and other symptoms, you should see your family doctor for an initial checkup. Remember that this is not a serious condition, but the doctor will want to rule out other diseases that show similar symptoms, such as inguinal hernia, varicocele, infection, cancer, or benign testicular tumor. Once an official diagnosis has been made, the solution is almost exclusively surgical, as drugs are not effective.
- Your doctor may prescribe an ultrasound, MRI, or computed tomography to better visualize the internal condition of the scrotum.
- Thanks to a bright light aimed at the testicles, it is possible to understand if the fluid is transparent (and therefore it is hydrocele) or cloudy. In this second case it could be blood and / or pus.
- Blood and urine tests are helpful in ruling out infections, such as epididymitis.
Step 2. Get surgery to drain the fluid
Once a diagnosis of hydrocele has been made, the least invasive procedure is aspiration of fluid from the scrotum through a needle. After giving you a topical anesthetic, the andrologist inserts a needle into the scrotum to puncture the hydrocele and drain the clear liquid that composes it. If the fluid is bloody or has traces of pus, the swelling was caused by trauma, infection, or even cancer. This procedure is very quick and does not require a recovery time; it is generally advised to rest for a day.
- Aspiration of the hydrocele is not done as often, because the fluid usually builds up again and other interventions are needed.
- In some cases the needle is inserted through the groin, if the hydrocele has formed in the upper part of the scrotum or partially outside it.
Step 3. Undergo complete hydrocele removal surgery
The most common and effective way to resolve a persistent or symptomatic hydrocele is the removal of its sac and the fluid contained; this surgery is called hydrocelectomy. With this procedure there is only a 1% chance of recurrence. The operation can be performed both open and laparoscopically; in this second case a small camera equipped with a sharp instrument is inserted into the scrotum. Usually the operation is performed in day surgery with general anesthesia. Convalescence lasts about a week or so, depending on whether or not the abdominal wall needs to be incised.
- In the case of newborns, the surgeon usually decides to perform an inguinal cut to proceed with the drainage of the fluid and the removal of the pouch. Then sutures are applied to strengthen the muscle wall; in practice it is an operation very similar to that of removing the hernia.
- Surgeons prefer to directly incise the scrotum of adult patients to eliminate fluid and the hydrocele sac.
- Immediately after hydrocelectomy it may be necessary to keep a drainage tube in the scrotum for a few days to get rid of any excess fluid.
- Depending on the type of hydrocele, surgery may be recommended to decrease the risk of a hernia to the area where the blood supply is interrupted.
Step 4. Rest during your recovery
In most cases, complete recovery from a hydrocele operation is relatively rapid. Most healthy men are discharged from the hospital a few hours after surgery, and one night's hospitalization is rarely required. Children should limit their activity (no rowdy games) and rest in bed or on the sofa for the first 48 hours. Adults should do the same, as well as abstain from sexual activity for at least a week, to stay safe.
- Most patients who undergo surgery for hydrocele can resume normal activities within 4-7 days.
- Possible complications from surgery that you need to watch out for are: allergic reaction to the anesthetic (breathing problems), continuous bleeding in or out of the scrotum, and even infection.
- The signs of bacterial infection are: groin pain, inflammation, redness, bad odor and even mild fever.
Advice
- Don't feel embarrassed about checking your scrotum from time to time. This is a perfect technique for identifying problems (such as hydrocele) before they turn into serious illness.
- Although rare, hydrocele can be caused by a parasitic infection (filariasis) in the testicles that causes swelling and elephantiasis.
- To relieve the post-operative discomfort of hydrocelectomy, you can use a jockstrap and ice pack wrapped in a thin sheet to control swelling.
- Sometimes the hydrocele occurs in conjunction with the inguinal hernia; both diseases can be resolved in a single surgery.
