Hydrocele Repair

• A hydrocele is a collection of fluid around the testicle in the scrotum. It is caused by an opening between the belly area (abdomen) and the fleshy sac that holds the testicles (scrotum). It has been present since your child was born (it’s congenital).
• Fluid drains from the abdomen into the scrotum where it builds up. You may notice that the hydrocele swelling goes down when your child is resting or lying down.
• When your child gets more active or cries, the hydrocele may get larger. This is normal and commonly seen when a baby has a communicating hydrocele. This means there is still an opening allowing fluid to shift around the body.
• A non-communicating hydrocele has already closed and will not have fluid changes throughout the day. In a non-communicating hydrocele, the connection between the belly and scrotum has already closed, but there is still fluid around the testicle. This amount of fluid does not change throughout the day.

• Your child’s healthcare provider can tell whether your child has a hydrocele during a physical exam.
• Only children with testicles have hydroceles.

• Most non-communicating hydroceles go away on their own after a few months as the body absorbs the fluid.
• If your child still has a communicating hydrocele when they are 1 or 2 years old with continued fluid changes, we plan for surgery. It will not go away on its own.

• We perform this surgery in the operating room with medicine (general anesthesia), so your child will be fully asleep and not feel pain.
• We make an incision near the crease between the abdomen and leg (in the inguinal space) and drain the fluid.
• Then we close the opening into the abdomen with small stitches that dissolve on their own and do not need to be removed.

Most children go home the day of surgery. If your child has another medical condition, they may need to stay overnight.

We created videos to explain how to care for your child after surgery. You can search for these titles on YouTube.

• “How to Care for Your Child After Hernia and Testicular Surgery” youtube.com/watch?v=kKgvviGyTLE

• “How to Care for Your Child After Urologic Surgery” youtube.com/watch?v=epLQn5D62wk

• Start with a light diet.
• When your child is fully awake, you can give clear liquids like water Jell-O, Popsicles and apple juice.
• Nausea and throwing up (vomiting) are common after surgery. If this happens, only give your child a small amount of clear liquids at a time.
• If your child is not sick to their stomach or throwing up and is fully awake, start their regular diet.

• We use tissue glue (Dermabond) to cover the incision. This will usually peel off on its own in 10 to 14 days.
• You won’t see any stitches on the outside skin. We used small stitches to close the skin that will dissolve over the next month and do not need to be removed.
• The scrotum may be red, darker than normal skin tone or look bruised and swollen to twice normal size after surgery.
• If the bruising or swelling does not go down, please bring your child back in for a clinic appointment.

• No showers or baths for 48 hours (2 days) after surgery.
• You can use a baby wipe to clean off food or poop.
• You can give a shower or bath after 2 days, but do not allow your child to soak in a tub for longer than 10 minutes.
• Avoid long baths or swimming for 2 weeks.

• Watch your child closely on the day of the surgery.
• Follow the steps below based on your child’s age.

• Younger children will limit their own crawling, walking and activities.
• Car seats and stroller straps are safe. Use as instructed by the manufacturer.
• Avoid any straddle activities with your child that would increase pressure between their legs.
• For 2 weeks after surgery, DO NOT let your child:
  
  • Do any straddle activities that would increase pressure between their legs
  • Sit on your hip
  • Bounce on your knee
  • Sit in a baby-wearing backpack (like Baby Bjorn, ErgoBaby) or a baby wearing wrap (like Moby or Solly wrap)
  • Use bouncing toys that have a harness

• Avoid strenuous activities, rough play or activities that involve straddle-activity. A good guideline is to keep both of your child’s feet on the ground for 2 weeks.
• For 2 weeks after surgery, DO NOT let your child:
  
  • Rock climb or use jungle-gyms
  • Attend gym class (PE or physical education)
  • Ride a bicycle or tricycle
  • Do after-school sports

• Your child may return to school when they no longer need frequent daytime over-the-counter pain medicine.

• After surgery your child will likely feel pain in the groin and scrotum.
• We partner with you and your child to relieve pain as much as possible. You know your child best. We encourage you to take an active part in their recovery. No matter the level of your child’s pain, believe they are hurting and respond right away. Your child should feel better the next day.

• Effective pain control will help your child feel better and heal faster. Start by giving your child acetaminophen (Tylenol) alternating every 3 hours with ibuprofen (Advil or Motrin) for the first 2 days after surgery and then you will use it as needed. Check with the healthcare provider first before giving any type of medicine to your child.
• In addition to medicine for pain, you can also help your child cope by distracting them with music, games, TV or videos.
• For more information about pain, read our handout “Acute Pain.” seattlechildrens.org/pdf/PE503.pdf

For questions or any of the concerns listed below, Monday to Friday, choose the phone number based on where your child had surgery:

• Urology Clinic at 206-987-2509 or nights, weekends and holidays, call 206-987-2000 and ask for the urology resident on call for urgent concerns from the list below.
• General Surgery at 206-987-0237 or nights, weekends and holidays, call 206-987-2000 and ask for the general surgery resident on call for urgent concerns from the list below.
• Send MyChart messages for non-urgent questions.

Urgent concerns:

• Fever higher than 101.5° F (38.6° C) for more than 24 hours
• Redness and swelling that spreads up into the stomach area
• Pain that can’t be controlled by the medicine prescribed
• Cannot pee for a span of 8 hours after surgery
• Throwing up (vomiting) 4 or more times in 12 hours