Techniques of Hydrocele Surgery

Dr. Shu has performed more than 100 cases of adult hydrocelectomy in the past 4 years, and he is one of the very few surgeons in the US who have extensive experience in performing total hydrocelectomy for the haitian patients with filarial hydrocele.


Anesthesia:

The hydrocele surgery starts under local anesthesia using the mixture of 2% Lidocaine and 0.5% Bupivacaine for spermatic cord block and scrotum infiltrated along the line of incision.

Hydrocele Surgery with partial excision/plication of the hydrocele sac:

  • A small incision in the mid of scrotum was performed.
  • The lining of sac (tunica vaginalis) is exposed and dissected
  • The fluid in sac is drained out via suction.
  • The hydrocele sac is partially excised and reduced (plicated) by absorbable suture or sewn together behind the spermatic cord.
  • Wound is closed up with absorbable suture.
  • A sterile dressing was then applied and supported with use of a scrotal jockstrap.

Following surgery, there will likely be some pain in the scrotum area, which may be managed with OTC pain relievers or prescribed pain medications. Ice packs should be applied for the first 24 hours to help with swelling, and activities should be restricted for several weeks until the hydrocele is fully healed. A jockstrap may be worn for 3 weeks following surgery to keep the scrotum elevated closer to the testicles. It may take up to 2-3 months for the swelling of the scrotum to go down completely. It is important to keep in mind that in a small percentage of patients, hydroceles may return even after surgery.