When to have it treated
Small, painless hydroceles can be left alone. Surgery is worth doing once the swelling interferes with comfort, movement, work or appearance, or when it is growing steadily.
- Swelling heavy enough to be uncomfortable while sitting, walking or working
- Steady increase in size
- Difficulty with clothing, hygiene or intercourse
- Uncertainty about the diagnosis on examination
- Any associated lump — which needs an ultrasound first to exclude a testicular tumour
Why aspiration is not a cure
Draining the fluid with a needle gives quick relief, and the fluid almost always comes back within weeks because the sac producing it is still there. Repeated aspiration also risks infection and makes later surgery harder. Surgery deals with the sac itself.
The procedure and recovery
A small incision in the scrotum; the sac is opened and either everted or excised, with dissolving stitches. It is a day-care operation under spinal or local anaesthesia. Expect scrotal swelling and bruising for one to two weeks — this looks worse than it is. Scrotal support, ice for the first 48 hours, desk work in three to four days and no heavy lifting for three weeks.
Hydrocele Surgery — common questions
Can a hydrocele go away on its own?
Infant hydroceles often resolve by one year. In adults they rarely disappear and tend to enlarge slowly.
Does hydrocele affect fertility?
Not usually. Very large or long-standing hydroceles can raise scrotal temperature, which may have some effect on sperm quality.
Will it come back after surgery?
Recurrence after proper hydrocelectomy is uncommon, unlike after needle aspiration where it is the norm.
How long is the hospital stay?
Day care in most cases — admission in the morning and home the same evening.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains hydrocele surgery in general terms; your own treatment plan depends on your reports and examination.