Laparoscopic Hydrocelectomy Treatment

Overview

Laparoscopic hydrocelectomy is a minimally invasive surgical procedure for removing or repairing a hydrocele. A hydrocele is a collection of fluid in the scrotum around the testes, leading to the scrotum's swelling. The scrotum is a part of the male reproductive system located beneath the penis that contains and protects the testes (two egg-shaped glands inside the scrotum that contain the sperm). 

Hydroceles can occur in infants and adults and one or both testes (bilateral). At times, hydroceles can resolve on their own without treatment, but if the hydrocele increases in size and cause symptoms (swelling, pain, redness), a surgical repair (hydrocelectomy) may be required.

What is Laparoscopic Hydrocelectomy?

Hydrocele is most common in newborns and occurs due to a developmental defect in the scrotal wall. In adults, infection or injury to the testes can lead to the development of hydrocele. Hydroceles can be of 2 types (in children and adults) -

• Communicating hydrocele: A communication path develops between the scrotum and the abdomen- the fluid may drain from the scrotum into the abdomen.
• Non-communicating hydrocele: This forms when the inguinal ring closes, but the fluid remains within the membrane of the testicles. This leads to an increase in the swelling of the scrotum over time.

In a Hydrocelectomy procedure, the fluid is drained, and the sac is shrunk to its original size. Hydrolectomy can be performed by 2 approaches- open or laparoscopy. Laparoscopic hydrocelectomy is an advanced, minimally invasive (involves small incisions with minimal bleeding and trauma) technique that uses a special scope known as a "Laparoscope." 

It is a flexible fiber-optic instrument with a light source and a tiny camera at the tip. When inserted into the abdominal cavity, it captures interior images and projects them on a large screen that guides the surgeon in the procedure. This procedure is done in infants with the aim of closing the opening between the scrotum and the abdomen (which normally should have closed before birth). In teenagers or adults, surgery may be required when the swelling becomes painful or increases in size to cause problems to the other tissues.

When is Laparoscopic Hydrocelectomy Recommended?

Hydroceles often do not require treatment and may resolve by itself within 6 months with painkillers. If you/ child > 2 years have the following symptoms, laparoscopic hydrocelectomy may be required:

• Swelling in the testes for more than 6 months
• Pain in one or both testicles
• Heaviness or increased pressure in the scrotum
• Not being able to be a parent after one year of trying
• If ejaculation is painful
• Presence of blood in semen
• Incontinence of urine (frequent urge to urinate)
• Painful urination
• Infection in the urinary tract or prostate
• Frequent urgent to pee or having painful urination
• Having a history of prostate or infection of the urinary tract

How to Prepare For a Laparoscopic Hydrocelectomy?

Preparation for hydrocelectomy is important as it will help your surgeon and you plan ahead. A urologist (a doctor specializing in male reproductive system disorders and urinary tract diseases) performs a laparoscopic hydrocelectomy.

• Your surgeon will ask for your medical history and perform a physical examination to check for pain, tenderness, and fluid accumulation around the testicles. 
• You will be advised to get some blood tests, like a complete blood count (CBC), that help detect any infections.
• Some imaging tests will be done, like an ultrasound, Magnetic resonance imaging (MRI), and Computed Tomography (CT) scans which can help rule out other causes of scrotal swelling.
• Inform your doctor about all medicines you are taking. This includes prescribed and over-the-counter medicines, vitamins, herbs, and other supplements.
•  If you are on blood thinner, you may need to stop taking them before surgery as instructed by your doctor to prevent bleeding during and after the surgery.
• Make sure to tell your doctor if you are allergic to any medications or any other things.
• Follow all instructions for not eating or drinking before surgery; you may be asked to avoid drinking or eating for at least six to eight hours before the procedure.
• As it is an outpatient procedure (daycare surgery), arrange for your family member or friend to drive you back home after the procedure.

How is Laparoscopic Hydrocelectomy Performed?

Laparoscopic Hydrocelectomy is a preferred option for treating hydrocele as it is a minimally invasive, safe, and effective procedure. The procedure takes 30 minutes to an hour and is performed under general anesthesia.

• You will be asked to come to the hospital on the day of the surgery.
• If you are a teenager/ an adult, your groin area will be shaved before the procedure.
• You will be asked to wash your groin area and scrotum thoroughly the night before and on the day of the surgery - this helps to reduce the chances of infections.
• Hydrocelectomy is generally performed under general anesthesia, so you will be asleep and pain-free during the procedure. You will have an intravenous line in your arm to provide fluids and any medication required.
• You will be made to lie supine (on your back) on the operating table.
• Your surgeon will make 3 to 4 incisions (cuts) on your abdomen, and a laparoscope and other instruments will be inserted through these incisions to perform the surgery. A laparoscope is a tube with a tiny camera at the end inserted into the area through a small surgical cut. It allows your surgeon to see the inside of the abdomen and the scrotum on an external video monitor. 
• The surgeon will remove or reposition the tissue that forms the sac around the hydrocele. This will prevent fluid from building up again. 
• A drain (thin tube) may be placed at the incision site for the fluid to be drained out. The drain will be removed 2 to 3 days after the surgery.
• If an inguinal hernia is present (in babies), the surgeon will repair it during the procedure.
• The incisions will be closed with sutures or staples, and surgical bandages will be applied.

What to Expect After a Laparoscopic Hydrocelectomy?

After the surgery, you or the child will be shifted to the postoperative care unit (PACU), where your vitals ( pulse, heart rate, respiration, and blood pressure) will be monitored. Ice packs will be applied over the area to reduce the swelling, and painkillers will be given for relief. Adolescent males and men will be given a jockstrap to wear, which helps reduce pain and swelling and prevent injuries to the genitals. Once your or the child’s vitals are stable, you will be sent home with the instructions on wound care.

In children- Recovery at home

• Minimal bleeding will occur, and you should not worry. Apply ice (ice wrapped in a towel) over the incision site for 24 hours frequently to reduce the swelling and pain. Apply ice packs for 15 minutes at a time.
• If your child has pain, give painkillers for relief. The pain will subside in 3 days.
• Depending on the child's condition, the drain will be removed after 1 to 3 days.
• If your child wears diapers, changing them every 2 to 3 hours is advisable - this helps keep the wound area clean.
• You will notice scab formation over the wound 2 weeks after surgery, which will fall off eventually.
• In some cases, swelling may occur on the scrotum or genitalia - this will subside gradually over a few weeks.
• You can bathe your child after 24 hours but do not soak your child in the bathtub or use a pool for 10 days post-surgery. This will increase the chances of infection.
• Refrain your child from riding bicycles, riding horses, or indulging in strenuous exercises for about 3 weeks after the surgery.
• Your child can go to school in about 4 to 7 days after the surgery.
• Complete recovery can take 2 to 3 weeks.

In adults- Recovery at home

• You will be advised to start ambulating. After surgery, you will have some swelling and pain on the incision site for a few days. Apply ice packs over the scrotum to reduce the swelling and ease the pain. Make an ice pack by wrapping ice cubes in a plastic bag on a soft towel. Do not apply ice directly on the skin as it may cause an ice burn. Take painkillers prescribed by your surgeon if there is pain.
• Follow the wound care instructions:
  • Do not wet the wound for 24 to 48 hours
  • Pat the wound dry after bathing- use a soft towel
  • Change your dressing regularly
  • Do not soak the wound as you may increase the risk of infection (do not swim, use the sauna, or bathtub until your surgeon permits you)
• Wear a jockstrap as advised by your surgeon
• Do not have intercourse for 4 weeks after surgery
• Do not drive while you are taking sedating pain medications.
• Do not lift heavy weights for 2 to 4 weeks post-surgery.
• You can resume work 4 to 7 days after surgery, but recovery takes 2 to 3 weeks.

What are the Benefits and Risks of Laparoscopic Hydrocelectomy?

As with other surgeries, laparoscopic hydrocelectomy comes with its own benefits and complications.

Benefits

• Quick surgery- The entire procedure is done in 30 minutes
• Minimal blood loss and injury to the tissues
• Fewer postoperative complications
• Faster recovery compared to traditional surgery
• Early return to work and other activities
• Relief from pain, heaviness, and discomfort
• Boosting of self-esteem in boys

Risks

• Bleeding from the site of the surgery.
• Infections in the area of the surgery.
• Recurrence of the hydrocele.
• Injury to the testicles and the nearby structure can lead to infertility (impotence).
• Risks from the anesthesia, such as breathing difficulty

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!