Hydrocele Surgery Operation in India :
Minimally Invasive Surgery
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Hydrocele is common in men aged over 40 years, new-born babies and young children.
In men, it usually occurs as a result of injury, infection or, rarely, because of testicular cancer. It may also occur after surgery on the testis, for example after vasectomy or reversal of vasectomy. If the cause is unknown it is called an idiopathic hydrocele.
In babies, hydrocele usually improves without treatment but surgery is recommended if it persists beyond 24 months of age.
Diagnosis of hydrocele
Contact your GP if you notice any change in the shape and size of your scrotum. Your doctor can usually diagnose hydrocele by shining a light underneath the scrotum (called transillumination). You may need a scrotal ultrasound to confirm the diagnosis.
Surgery is usually recommended if the hydrocele is causing discomfort.
What are the alternatives to surgery?
Hydrocele can be left untreated if it's not causing any discomfort; otherwise surgery is usually the best option. Alternatively, the fluid can be drained with a needle and syringe. This method, however, is rarely used as it's painful, can cause infection and hydrocele may re-occur.
Preparing for your operation
Your surgeon will explain how to prepare for your operation. For example if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
Hydrocele surgery is routinely done as a day case. This means you have the operation and go home the same day.
Hydrocele surgery is usually done under general anaesthesia. This means you will be asleep during the operation. If you prefer, it can be done under local anaesthesia if absolutely necessary. This completely blocks feeling from the scrotum area and you will stay awake during the operation.
If you are having general anaesthesia, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
You may be asked to shave your scrotum, or this may be done at the hospital. Your nurse may check your heart rate and blood pressure, and test your urine.
Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
About the operation
The operation takes about 10 to 20 minutes.
A small cut is made in your scrotum to reach the hydrocele. The fluid is drained from around the testicle through a cut in the tunica vaginalis or 'envelope' surrounding the testis. The tunica is stitched in such a way that fluid can't reform in this layer. The cut is closed with dissolvable stitches.
What to expect afterwards
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You will be wearing supportive underwear to help relieve any discomfort.
You will be able to go home when you feel ready. Ideally you will have been able to pass urine before you go home.
You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
Your nurse will give you advice about caring for the healing wound, hygiene and bathing before you go home. Dissolvable stitches will disappear on their own in seven to 10 days.
Recovering from hydrocele surgery
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
General anaesthesia can temporarily affect your coordination and reasoning skills, so you shouldn't drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.
You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon's advice.
Keep the area clean and dry for the first two days. After this you can bathe and shower but you should dry the area gently and thoroughly afterwards.
Continue to wear close-fitting underwear day and night for a few weeks. This will help ease any discomfort and swelling. Don't do any heavy lifting or vigorous exercise for the first two weeks. You can have sex as soon as you feel comfortable.
If you develop any of the following symptoms contact your GP as you may have developed an infection :
- Difficulty in passing urine
- Severe swelling or redness of the scrotum
- Bleeding from the wound
- Discharge from the wound
- Increasing pain or pain that can't be controlled with painkillers
- High temperature
What are the risks?
Hydrocele surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.
You will have some bruising and swelling in the scrotal area for the first two weeks.
This is when problems occur during or after the operation. Most men are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of hydrocele surgery are uncommon, but can include :
- Bleeding inside your scrotum (haematoma) : You may need further surgery to stop the bleeding and drain the area
- Difficulty in passing urine : You may need a temporary catheter to help drain the urine from your bladder
- Damage to spermatic cord : This can cause the testicle to shrink
- Recurrence : The hydrocele may come back
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.
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