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Hydrocele
Information for parents/carers
A hydrocele is a collection of fluid around the testicle. This may be
due to local injury, infection or sometimes for no apparent reason.
In children, a hydrocele is usually a problem from birth
(congenital) and results from a communication between the scrotal
sac and abdominal cavity. This is known as a patent processus
vaginalis (PPV)
The swelling may cause pain in the testicle and fluid retention
which therefore needs draining. Any communication between the
fluid filled sac and the abdominal cavity will also be tied off at the
time of the operation. This is performed under general
anaesthetic by making a small incision (cut) in the groin.
This procedure is also known as ligation of a patent processus
vaginalis (PPV).
What are the alternatives?
Just to observe as the fluid may resolve in time.
What is the treatment/procedure?
Surgery will be performed under a general anaesthetic as a day case.
Your child will be a sleep throughout the procedure.
A small incision is made in the groin. The fluid filled hernia sac is then
located and tied off.
A local anaesthetic is then usually injected into the wound at the end of
the operation to reduce discomfort. In younger children the
anaesthetist may discuss a so called caudal anaesthetic which is
similar to an epidural. Please ask for leaflet ‘Caudal analgesia in
children’ which gives further information.
What will happen to your child on admission to the
ward?
On your child’s admission the nursing staff will obtain details about
your child’s previous illnesses and any allergies that they may
have and ask some basic details.
Your child will have their blood pressure, temperature, pulse and
weight recorded.
A doctor will examine your child and he/she will ask the parents or
guardian with legal responsibilities to sign a consent form. A mark
will be drawn on your child with a special marker pen to indicate
the correct side of your child's surgery.
An anaesthetist will also come to see your child before going for
his operation and will discuss with you the procedure for the
anaesthetic and any concerns that you may have. (Please ensure that
you have read the You and Yours Anaesthetic booklet).
A local anaesthetic cream will be applied to the back of your
child’s hands to make the skin numb. When your child goes to
theatre, the cream is removed and the anaesthetist places a small
plastic tube called a cannula in to the vein so that medications can be
given. Paracetamol and Ibuprofen(analgesia/painkillers) are also
given orally to your child before theatre.
When your child is called to go down to theatre only one parent
will be allowed to accompany them. This is because of the lack of
space in the anaesthetic room.
Advice after surgery
Once the operation is finished one parent will be allowed into the
recovery room to escort their child back onto the ward.
On their return your child will still be sleepy and may be sick due
to the anaesthetic.
The nurse will check the blood pressure and pulse immediately on
their return and again as often as the nurse feels necessary.
Your child will be allowed to drink as soon as they request to do
so. Once they have had a drink without feeling sick they will be
allowed some food if they wish.
The length of stay in hospital will depend on how quickly your child
recovers from the operation. However this operation is usually done as
a day case. Before discharge your child will need to have had a wee/
pass urine.
If the operating surgeon is happy, your child may be discharged by the
nursing staff before the end of the theatre list if he is well enough for
discharge. This will be indicated on the operation notes and means
you will not see the surgeon before you leave. If you feel you need to
speak to the surgeon, please discuss with the nursing staff.
What are the Risks and side effects to the treatment/
procedure?
Most procedures have a potential for side effects. Reassuringly,
although these complications are well recognised, the majority of
patients do not suffer any problems after a urological procedure.
Common (greater than 1 in 10)
•
Swelling of the scrotum which may last several days. This may
be due to a collection of blood called a haematoma and will
reabsorb over time.
•
Seepage of yellowish fluid from the wound several days after
the operation.
•
No immediate change in the appearance of the swelling for
several weeks.
Occasional (between 1 in 10 and 1 in 50)
•
Occasionally a larger hernia may be found which requires
repair with stitches or a mesh graft.
•
A collection of blood around the testis may require surgical
treatment.
Rare (less than 1 in 50)
•
A wound infection or the testis may occur that requires
treatment.
•
The fluid recollects and requires further treatment.
Discharge Advice
Most children will make a rapid recovery although, your son may
complain of the groin area being painful for several days.
Paracetamol /ibuprofen should be given if required.
There is usually a small dressing applied and this needs to remain in
place for up to 5 days whilst the wound is healing. A bath should be
avoided during this time.
The stitches are absorbable/dissolvable so do not need to be
removed but they can take 2-3 weeks to dissolve.
Infants wearing nappies should be changed regularly to keep urine
away from the wound.
It is advisable to wear supporting underpants after surgery to support
the scrotum if this is appropriate.
Vigorous exercise such as school sports, cycling, climbing and
swimming should be avoided/discouraged for the first 2 weeks whilst
the wound is healing.
Your son should be able to return to school once you feel they are
comfortable and do not require regular analgesia such as
paracetamol/ibuprofen.
In young adults, it is advisable that they do not attend work for a period
of 10-14 days.
An outpatient appointment will normally be arranged for 6-8 weeks
after the operation to review the procedure undertaken.
What symptoms would require me to contact the
GP?
•
If there is any bleeding from the wound
•
If there is any excessive discharge from the wound
•
Inflammation/excessive swelling/excessive redness around the
wound
•
Excessive pain that is not controlled with paracetamol or
ibuprofen
If you require any further advice please contact:
Pinderfields Hospital
tel: 01924 541932
We are committed to providing high quality care. If you have
a suggestion, comment, complaint or appreciation about the
care you have received, or if you need this leaflet in another
format please contact the Patient Advice and Liaison
Service on:01924 543686 or email: [email protected]
To contact any of our hospitals call:0844 811 8110
To book or change an appointment call:0844 822 0022
307d
Updated March 2014
Review Date 2017
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