Hydrocele Treatment

Hydrocele is usually not dangerous, but it may lead to pain due to reduced blood supply to the penis in some cases. This may require immediate treatment to avoid severe complications like testicular cancer. 
Hydrocele is commonly seen in newborns and usually disappears without any treatment by the age of one. Older boys and adult men may develop a hydrocele due to an injury or inflammation of the scrotum.

Types:
The different types of hydroceles are:

1. Communicating hydrocele: This type of hydrocele has communication with the abdominal cavity fluids. It is caused by the failure of the processus vaginalis (a thin membrane that extends through the inguinal canal into the scrotum). If this membrane stays open, it can lead to the development of a hernia and a hydrocele. The scrotum will appear large or swollen and could change in size throughout the day.
2. Non-communicating hydrocele: In this type of hydrocele, the inguinal canal will close, but there will still be some extra fluid around the testicle in the scrotum. This condition could be present at birth or may develop many years later without any apparent cause. This type of hydrocele normally remains the same size or has extremely slow growth.
3. Nuck’s hydrocele: This is a rare type of hydrocele found in people without testicles. It can occur in the pelvic wall lining and could lead to painful swelling in the lymph nodes of the groin. 

Causes:
In the case of babies, the hydrocele may develop in the womb, when the passage that allows the testicles to move from the abdomen to the scrotum fails to close entirely and normally disappears without treatment within a couple of months.
In the case of adolescents and adult men, the hydrocele may develop due to an injury or inflammation that occurs due to an infection within the scrotum.

Risk factors:
The risk of developing a hydrocele is greater in the following cases:

• Premature babies
• Newborn baby boys
• Inflammation or injury to the scrotum
• Infections, such as sexually transmitted infections 

Symptoms

Symptoms:
The symptoms associated with a hydrocele are:

• Feeling heaviness in the scrotum
• Swelling in the scrotum
• Usually painless

Diagnosis

1. Physical examination: The doctor will check for tenderness in an enlarged scrotum. The doctor will apply pressure to the abdominal and scrotal areas to check for an inguinal hernia. Transillumination uses a light that shines through the scrotum and can help the doctor in showing the clear fluid that surrounds the testicle.
2. Blood tests: Complete blood count helps the doctor to check the various parameters of blood, as well as detect possible infections like epididymitis.
3. Urine tests: This test helps the doctor in evaluating the cause of hydrocele and check if there is any underlying infection.
4. Ultrasound: This is a type of imaging test performed to rule out complications such as tumors, hernias, or other possible causes of scrotal swelling.

Treatment

Hydrocele in newborn baby boys usually disappears on their own without any treatment within the first six to twelve months of life. If the condition does not get treated on its own, the following different types of treatments can be performed:

1. Non-surgical treatment: 
Aspiration and sclerotherapy: Aspiration is a minimally-invasive type of procedure involving the injection of a needle into the hydrocele to withdraw the fluid. Once the fluid is removed, the doctor will inject a sclerosing agent that uses a combination of sodium tetradecyl sulphate inside the sack around the testicle. This helps in the prevention of fluid build up.

This type of procedure is usually performed in men having a higher risk of complications during surgery. There is a slight possibility that the hydrocele may return after a few months, and another session of aspiration and sclerotherapy may be needed after that.

2. Surgical treatment:

• Open hydrocelectomy: This procedure is generally done under general anesthesia, that is, the patient will be put to sleep during the procedure. An incision or cut is made by the surgeon in the scrotum or groin area to drain out the fluid via suction. The surgeon will then close the communication to the canal between the scrotum and abdominal cavity, before removing the hydrocele sac. The incision is then closed using sutures or surgical strips.
• Laser hydrocelectomy: This form of hydrocele treatment is long-lasting and has a reduced risk of recurrence and a rapid rate of recovery with no blood clot formations or infection. A high-intensity laser beam is used in this procedure to drain the accumulated fluid. The doctor will then remove the sac to prevent the recurrence of the condition. This procedure takes less than half an hour to complete and the patient can usually go home six to twelve hours after the procedure. 

Risks

The complications associated with untreated hydrocele are:

• Infection
• Tumor
• Reduced sperm production or function
• Inguinal hernia (due to the trapping of the loop of the intestine in the abdominal wall)
• The complications associated with surgery performed to treat hydrocele include:
• Bleeding
• Infection
• Blood clot formation
• Allergic reaction to the anesthesia used
• Nerve damage
• Scrotal injury
• Breathing problems
• Hydrocele recurrence 

After Procedure

• It is normal to have some pain after surgery. This pain usually goes away on its own in approximately one week.
• The stitches at the site of the incision normally dissolve on their own.
• Have regular follow-ups with your doctor to check for recurrence of the condition.
• The results of hydrocelectomy may take approximately six to eight weeks to show up.

Home remedies:

• Take plenty of rest after surgery.
• Ice pack application after surgery can help in relieving swelling and discomfort.
• A support strap for the scrotum can be worn to ease the discomfort.
• The doctor may prescribe pain-relieving medications to relieve your discomfort.
• Keep the incision area clean using sponge baths or showers to prevent infection.
• Avoid strenuous activities and heavy lifting for at least three weeks after surgery.

Cost of Hydrocele treatment in India-

The cost of hydrocele treatment in Mumbai is between INR 25,000 to INR 95,000.
The cost of hydrocele treatment in Delhi is between INR 22,000 to INR 92,000.
The cost of hydrocele treatment in Bangalore is between INR 22,000 to INR 92,000.
The cost of hydrocele treatment in Chennai is between INR 20,000 to INR 85,000.