Hydrocele
This leaflet explains hydrocele and what to expect when your child comes to Great Ormond Street Hospital for an operation.
Contents
What is a hydrocele and what causes them?
A hydrocele is a very common condition affecting boys, where a fluid filled sac develops inside the scrotum, making it look swollen. It is not painful and feels like a balloon filled with water. One or both sides of the scrotum can be affected.
While your child was developing in the womb, the testicles were developing inside the abdomen. Towards the end of pregnancy, the testicle travel through a passage into the scrotum. A hydrocele can develop when this passage fails to close, allowing fluid from the abdomen to flow through it to the scrotum. This causes the fluid-filled sac to develop.
Hydroceles can be associated with a hernia, but a thorough check up of the groin area will confirm or rule out the chance of a hernia. For more information, please see our leaflet Hernias in children.
Can a hydrocele be prevented?
There is no known way of preventing hydroceles. It is not due to anything a mother did during pregnancy.
How is a hydrocele diagnosed?
The doctors will feel your child’s scrotum to see if the swelling is caused by fluid or something solid. To confirm that the swelling is a hydrocele and filled with clear fluid, the doctor will shine a torch through the scrotum. The outline of the testicles will show up and the rest of the scrotum will show the light.
How is a hydrocele treated?
Most hydroceles go down within a few months of birth, but occasionally they last longer. If a hydrocele is still present after two to three years or is causing any problems, an operation called a hydrocelectomy might be suggested. If the child also has a hernia, this will be corrected in the same operation. In certain circumstances, the doctor might suggest draining off the fluid using a needle, but it is quite common for the fluid to come back using this method, so an operation is usually preferred.
What happens before the operation?
You will receive information about how to prepare your child for the operation in your admission letter and our Welcome to GOSH booklet. Your child should not have anything to eat or drink before the operation, for the amount of time specified in the letter. It is important to follow these instructions, otherwise your child’s operation may need to be delayed or even cancelled.
The day you and your child come to hospital for the operation, your child’s surgeon will visit you to explain about the operation in more detail, discuss any worries you might have and ask you to give permission for the operation, by signing a consent form. An anaesthetist will also visit you to explain about the anaesthetic and pain relief after the operation. If your child has any medical problems, such as allergies, please tell the doctors. Please also bring in any medicines your child is currently taking.
What does the operation involve?
The operation is carried out under general anaesthetic and lasts for about an hour. Once your child is asleep, the surgeon will make a small incision (cut) on the lower abdomen to remove the fluid inside your child’s scrotum. The passage between the abdomen and scrotum will then be sealed off. The cut will be closed with dissolvable stitches.
What are the risks of surgery?
All surgery carries a small risk of bleeding during or after the operation. There is a small risk of a blood clot forming in the area, damage to the scrotum and the tissues inside. There is also a small risk of infection, but your child may be given antibiotics as a precaution.
Every anaesthetic carries a risk of complications, but this is very small. Your child’s anaesthetist is an experienced doctor who is trained to deal with any complications. After an anaesthetic some children may feel sick and vomit. They may have a headache, sore throat or feel dizzy. These side effects are usually short-lived and not severe.
What happens after the operation?
Your child will recover from the anaesthetic on the ward. Once he feels comfortable and has had a drink, you will be able to take your child home. We recommend that you bring in some loose clothing for your child to wear home and for the next few days, as this will be a lot more comfortable.
When you get home
It is quite normal for your child to feel uncomfortable for a day or two after the operation. Usually paracetamol (Calpol® or Disprol®) will be enough to relieve any pain if you give it every four to six hours for the next day. You do not need to wake your child during the night to give the medicine.
If your child needs stronger medicine, we will give you some before you go home. If when you get home you feel that your child needs more powerful pain relief medicines, you should call your GP. Please see the table at the end of this leaflet for details of which pain relief medicines to give and at which times.
Your child may feel sick for the first 24 hours after the anaesthetic. You should encourage your child to drink plenty of fluids, and as long as he is drinking, it does not matter if he or she does not feel like eating for the first couple of days.
Your child should not have a bath or shower for two days after the operation. After this, it is fine for your child to have a shower, but try to avoid long baths as this may cause the scab to soften and fall off too early.
Your child may feel tired and a bit clumsy for the first day or so after the operation, so avoid anything that might lead to a fall. Sit-on toys or bicycles will be uncomfortable so should be avoided until the area has healed. Your child should be ready to go back to school or nursery about a week after the operation.
The stitches will dissolve on their own within two weeks or so. The wound site may be closed by steri-strips® (plastic strips which are stuck on the skin and used, like stitches, to close wounds). The steri-strips® usually fall off of their own accord. If they have not fallen off within a week, you can soak them off using a wet flannel.
You should call your GP or the ward:
- If your child is in a lot of pain and pain relief medicines do not seem to help;
- If your child has a high temperature;
- If the wound site looks red or inflamed and feels hotter than the surrounding skin;
- If there is any oozing from the wound;
- If your child is not drinking any fluids after the first day back home
What is the outlook for children with a hydrocele?
Most hydroceles go down of their own accord within a few months, but some need to be removed in an operation. This operation is minor and the scar fades until it is hardly noticeable. There are no long-term effects of having a hydrocele; it does not affect the testicles or a boy’s future fertility.
If you have any questions, please telephone Louise Ward on 020 7829 8814
Ref: F050187 © GOSH Trust July 2005
Compiled by the Department of Urology and Louise Ward
in collaboration with the Child and Family Information Group.
This information does not constitute health or medical
advice and will not necessarily reflect treatment at other hospitals.
If you have any questions, please ask your doctor. No liability can be
taken as a result of using this information.
This page was last updated on 8 August, 2008
UCL Institute of Child Health
Great Ormond Street Hospital for Children NHS Trust
