A surgical procedure performed using excision or window (Lord) techniques when fluid accumulating around the testicle causes scrotal swelling and discomfort.
Indication
- Fluid accumulation in the scrotum that is enlarging and causing discomfort
- Persistent hydroceles that do not regress with conservative observation
- Cases causing pain, pressure, or limitation in clothing and activity
- Hydrocele that refills despite repeated needle aspiration
- Repairs planned together with an accompanying inguinal hernia or varicocele
Preparation
- No food or drink for 6-8 hours before the procedure
- Scrotal ultrasound to evaluate the testicle and the hydrocele
- Blood tests and anesthesia evaluation
- Any active skin infection is treated beforehand
- Blood thinners are adjusted according to physician guidance
How it's performed
- General or regional anesthesia is administered
- An appropriate incision is made through the scrotum or groin region
- The hydrocele sac is opened and the accumulated fluid is drained
- In the excision technique, the excess sac tissue is removed; in the window/Lord technique, the sac is reduced and folded
- Application of a sclerosing agent may be an alternative in selected patients; recurrence rates are generally higher
- If drainage is needed, a short-term drain is placed and the skin is then closed with sutures
Post-procedure
- Most patients are discharged the same day
- Light activity for 1-2 weeks; heavy lifting is restricted
- Use of scrotal support and appropriate underwear
- Return to sexual activity is generally after 2-3 weeks
- Complete resolution of swelling may take weeks; a follow-up examination is scheduled
Risks
- Hematoma or swelling in the scrotum
- Wound infection
- Recurrence of the hydrocele (more frequent with certain techniques)
- Temporary pain, numbness, or scrotal tenderness
- Very rarely, injury to the testicle or epididymis
FAQ
Does a hydrocele resolve on its own?
Adult hydroceles generally do not regress spontaneously; some hydroceles in infancy may close in the first years of life.
Is needle drainage of the fluid sufficient?
Aspiration provides temporary relief, but the fluid usually re-accumulates. Surgery is required for a lasting solution.
What is the difference between excision and the window technique?
In excision, the excess sac tissue is removed; in the window/Lord technique, the sac is shortened and folded. The choice depends on the size of the hydrocele and the thickness of the wall.
Will the surgery affect my ability to have children?
Standard hydrocele surgery does not negatively affect fertility; in fact, relieving the pressure it creates provides comfort.
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