A hydrocele testis is an accumulation of fluid in the most internal of membranes containing a testicle (tunica vaginalis); it can affect one or both scrotal sides.
Hydrocele can be distinguished in primary and secondary and hydrocele repair surgery may be necessary. A primary hydrocele is thought to be caused by a defective absorption of fluid secreted between the two layers of the tunica vaginalis. It causes a painless swelling on the affected scrotum side. Secondary hydrocele is usually caused by an underlying pathological process such as trauma, inflammation, infection, or malignancies.
Hydrocele can cause a visible swelling of the scrotum which feels like a small fluid-filled balloon, variable in size, smooth, and mainly located in the front of the testis. Hydrocele repair surgery may be needed to treat this condition. Hydrocele are generally painless and harmless. Most of the time they diminish by themselves or just remain without further growth. They may cause discomfort if they grow in size, and larger hydrocele may require surgical removal (i.e., hydrocele repair surgery).
Diagnosis of hydrocele is through physical examination where a hydrocele can easily be seen when light is observed through the testicle. Hydrocele fluid is usually clear and light will shine through (translumination). Further diagnostic modalities include ultrasound study and other imaging studies, after the examination, hydrocele repair surgery may be necessary. If hydrocele require a treatment, it usually involves a surgical removal which is usually called hydrocele repair surgery.
Dr. Elist treats a hydrocele through hydrocele repair surgery by removing the abnormal fluid filled sac in the scrotum or in the inguinal canal. After injecting an area with a local anesthetic and using aseptic techniques, Dr. Elist makes an incision in the scrotum or in the inguinal area. Care is taken to keep the hydrocele intact while it is dissected free of its attachments to the testis and other structures. During the hydrocele repair surgery, the sac is opened high along its front surface and the testis is pushed up through the sac and out through the incision. This inverts the hydrocele sac which is tacked by suturing to the spermatic cord structures behind the testis. The testis is returned to the scrotum and is anchored to the inside of the scrotum with three sutures to prevent later torsion or twisting of the testis. A rubber drain may be left in the scrotum after the hydrocele repair surgery and the incision closed in layers by suturing.