Hydrocele surgery: duration, cost and step by step

• Testicular hydrocele is the accumulation of peritoneal fluid around one or both testicles.
• Although hydrocele may resolve on its own in children, the only remedy for adults is surgical treatment or hydrocelectomy.
• Generally, testicular hydrocele does not present serious symptoms beyond swelling of the scrotal sac, although they can become complicated, causing pain and heaviness in the area.

When we talk about a hydrocele, we are referring to the accumulation of fluid in the scrotal sac next to the testicle, so that the scrotum is enlarged and can cause pain and discomfort in the area, preventing the patient from leading a normal life.

This type of condition usually causes greater pain and discomfort, therefore, the most advisable and effective treatment is surgery.

We can differentiate between three types of hydrocele, these are:

• Congenital hydrocele: this type of hydrocele consists of the accumulation of peritoneal fluid at birth due to an alteration of the layer called the tunica vaginalis or due to the persistence of a duct that should disappear at birth and which communicates the interior of the abdomen with the testicle.
• Acquired hydrocele: an accumulation of peritoneal fluid caused by an alteration between the entrance and exit of the fluid between the two parts of the tunica vaginalis.
• Hydrocele of idiopathic origin: this type of accumulation in the tunica vaginalis can be produced by different traumatic or infectious causes, testicular torsion or as a consequence of tumour formation.

On the other hand, it is also possible for hydrocele to occur in both testicles. This condition is called bilateral hydrocele. It is usually due to the formation of several cysts around the testicles or the presence of a separate cyst in each testicle.

The possible causes of testicular hydrocele include the following:

• Appearance from birth: it appears in newborn babies, when the tunica vaginalis of the testicle has not closed completely, so that communication with the peritoneal cavity is preserved and this leads to fluid flowing into the scrotal cavity.
• Other conditions: hydrocele formation is possible as a result of other conditions such as infection, testicular torsion, trauma, epididymitis, tumour, etc.
• As a result of previous surgery: following surgery in or near the testicular area, such as vasectomy, varicocele or inguinal hernia surgery, hydrocele may also be the cause of hydrocele.

The decision to treat a testicular hydrocele depends mainly on whether or not it causes bothersome symptoms and on the type of hydrocele involved. It should also be noted that hydroceles often disappear on their own in children (between 18-24 months), but not in adults.

In addition, you should know that if you have any of the following symptoms, the most advisable option is to resort to surgical treatment:

• Becomes too large: If fluid continues to accumulate around the testicle, it is possible that in addition to heaviness and discomfort, the excessive enlargement may cause major complications, such as circulation problems.
• Causes blood circulation problems in the area: As we mentioned in the previous situation, the accumulation of fluid can put excessive pressure on the venous structure inside the scrotum, causing complications that can endanger the functioning of the reproductive organ.
• Infection is present: If infection is present, it is important to treat it.
• It is painful or uncomfortable: This is the main reason for surgery.
• It is associated with a hernia: After the appearance of an inguinal hernia, it is possible for peritoneal fluid to pass through the duct created by the displacement of the intestine into the scrotum, enlarging the scrotal sac.

In any case, the above indications are of a general nature and should be consulted with a Urology Specialist, adapting the treatment to your particular case.

In this section, we explain the entire procedure from requesting a consultation until you are fully recovered after the operation.

The first step you should take is to contact our patient service team or request a surgical assessment consultation with one of our Urology Specialists via the website. Our consultants will confirm the time and dates that best suit your preferences and answer any questions you may have about the process.

Surgical assessment consultation

On the day of the appointment and at the consultation, the specialist will conduct a medical interview in which you will be asked about the symptoms and problems caused by the appearance of the hydrocele. In addition, the doctor will also perform a physical examination to determine whether or not a hydrocelectomy is necessary, indicating the most appropriate treatment for you.

After the consultation, our patient service advisor will contact you to find out how the consultation went and, if necessary, confirm your availability to continue with the process and inform you of the steps you will need to take.

Pre-operative hydrocele surgery

Before surgery, a preoperative examination is necessary, as it will help to prevent risks during surgery, ensure the type of anaesthesia and confirm whether or not you are fit for the operation. The following tests will be necessary:

• Electrocardiogram: This test allows the surgeon and anaesthetist to know your cardiovascular health.
• Blood test: The purpose of this test is to determine that you do not have any abnormalities or pathologies such as infections, which can delay surgery until it is under control.
• Chest x-ray: This is a test that is only performed if the doctor determines it necessary, to ensure that you do not have an infection and that your trachea is correctly aligned, in case you require intubation.

Hydrocelectomy surgery: step by step

To put your mind at ease, here's how the day of surgery will unfold and the steps your surgeon will take during your surgery:

• About an hour before the surgery, you may be asked to apply a cream to the area around the scrotum, which has been shaved beforehand.
• Once in the hospital, in the operating theatre, the urological surgeon may give you a series of antibiotics to reduce the chance of infection after surgery.
• The anaesthetist will then sedate you, usually using spinal anaesthesia.
• After anaesthetising you, the surgeon will make an incision in the scrotum, no more than 3-4 centimetres long. This incision will allow the surgeon to reach the area where the hydrocele is located. In the case of a bilateral testicular hydrocele (in both testicles), the incision will be made first on one side and then on the other.
• After dissection of all the scrotal layers, the surgeon reaches the tunica vaginalis, where the fluid accumulation is located.
• Once the testicular hydrocele is located, the surgeon will proceed to aspirate the fluid accumulated in the hydrocele until the sac decreases in size, so that it can also be removed. The remaining fluid will then be removed.
• Once the fluid and sac have been removed, the hydrocele problem will be solved and the area will be sutured.
• Once the surgery is over, you will have to stay in the recovery room for approximately one hour.

You can usually leave the hospital on your own within a few hours after surgery, although it is recommended that you stay overnight.

One of the most common concerns is the time involved in the whole process, both the duration of the intervention and the recovery stage after the procedure. In this section you can find out how long it will take you to get through each stage of the process and return to normality.

Time in the operating theatre

After handing in all the necessary documentation at the hospital and being prepared to enter the operating theatre, the time you will spend there is quite short, being approximately between 30 and 60 minutes, depending on whether it is a unilateral or bilateral hydrocele.

Hospital stay

Although this is an outpatient operation, it is advisable that you stay in hospital for at least 1 day after surgery to rest properly and to ensure that everything has gone well.

Recovery period

After discharge, it can usually take 4 to 5 days to return to normal daily life, although the scar may take a little longer to heal.

To discuss the price of testicular hydrocele surgery, we take as a reference the price of the service we provide at Operarme.

Through our company, the surgical treatment for testicular hydrocele is 2.490 € all-inclusive. By this we mean that our price includes all the necessary elements to be able to perform the surgery under normal conditions, such as:

• Preoperative examination, including blood tests, electrocardiogram and, if necessary, a chest X-ray.
• Medical fees and those of the assistants until medical discharge.
• Fees for anaesthetist, anaesthesia and necessary medical gases.
• Stay in a single room with a spare bed, hotel and laundry services for the patient for 1 day.
• Products for the hygiene and care of the patient, disposable and non-disposable, and feeding of the patient during the stay.
• Expenses related to the surgical procedure: booking and use of the operating theatre, medical instruments, equipment, consumables and medications specific to the surgical procedure (not cytostatics or monoclonal antibodies or derivatives).
• Complementary tests during the hospital stay (blood tests, electrocardiogram or chest x-ray).
• Stay in the post-surgical recovery room, monitoring and necessary treatments.
• Medical complications insurance, which covers possible eventualities such as the need for an extra day in hospital.

In addition, we offer you the possibility, at Operarme’s expense, of a vehicle to take you to the hospital on the day of admission and from the hospital to your home on the day of discharge (you can read the conditions of the free transfer service here), as well as the support and help of our patient service team, who will help you and answer any queries you may have.

If you are still interested in the testicular hydrocele surgery with us, just click on the image below to request a free surgical assessment consultation with one of our Urology Specialists: