Hydrocele: When to Consider Surgery for Testicular Fluid Accumulation

Regarding Hydrocele?

I would like to inquire about hydrocele/scrotal edema.
I have persistent hydrocele on my left testicle that hasn't resolved.
Although it isn't significant enough to cause a feeling of heaviness (it’s not noticeable unless touched), I have studied some detailed knowledge about testicular anatomy.
I understand that there is a method that addresses the symptoms but not the underlying cause, which involves using a syringe to aspirate the fluid.
I have done this a few times and have managed to drain it completely, but I know that the fluid tends to accumulate again after some time.
Additionally, I have always felt that my left testicle is much more sensitive than the right one, and when I apply pressure with my fingers, the left testicle feels firmer and harder than the right.
I am wondering if I might have previously injured my left testicle, and that the injury never fully healed, leading to the ongoing fluid accumulation.
Is surgical intervention necessary for this hydrocele, or can it be left untreated as long as it does not affect appearance, mobility, and there is no pain or heaviness?

RML, 20~29 year old female. Ask Date: 2015/06/01

Dr. Li Yilun reply Urology

Your information has been mostly accurate, but it's important to note that different patients have varying conditions.
It cannot be determined solely from your brief description.
Therefore, it is emphasized that if symptoms do not improve or worsen, it is still advisable to consult a professional physician for evaluation and examination to avoid delaying the condition.
Physicians often need to inquire about medical history, perform visual examinations, palpation, and other tests to confirm the diagnosis and treatment plan.
It is recommended that individuals with health issues seek evaluation and treatment from a nearby urologist.

Reply Date: 2015/06/01

More Info

Hydrocele, or fluid accumulation in the scrotum, is a condition that can be concerning for many men. It is characterized by the presence of a fluid-filled sac surrounding one or both testicles. While hydroceles are often benign and may not cause significant symptoms, understanding when surgical intervention is necessary is crucial for managing this condition effectively.

In your case, you mentioned that the hydrocele on your left testicle has not resolved and that it does not cause a heavy sensation or significant discomfort. This is a common scenario, as many hydroceles are asymptomatic and may not require immediate treatment. However, there are several factors to consider when deciding whether surgery is warranted.

1. Size and Symptoms: If the hydrocele is small and does not cause pain, discomfort, or a feeling of heaviness, it may be reasonable to monitor the condition. However, if the hydrocele grows larger, causes discomfort, or affects your quality of life, surgical intervention may be necessary.
2. Recurrence After Aspiration: You mentioned that you have attempted aspiration (using a needle to remove the fluid) multiple times, but the fluid has returned. This is a common issue with hydroceles, as aspiration often provides only temporary relief. If you find yourself repeatedly needing to aspirate the fluid, it may be a sign that a more permanent solution, such as surgery, is needed.

3. Sensitivity and Hardness: You noted that your left testicle feels more sensitive and harder than the right. This could indicate an underlying issue, such as inflammation or a previous injury that may have contributed to the hydrocele. It is essential to have this evaluated by a healthcare professional to rule out any other conditions, such as infection or testicular torsion, which may require urgent treatment.

4. Potential Complications: While hydroceles are generally not harmful, they can sometimes lead to complications, such as infection or discomfort. If you experience any changes, such as increased pain, swelling, or redness, it is crucial to seek medical attention promptly.

5. Surgical Options: If surgery is deemed necessary, the procedure typically involves removing the sac that contains the fluid. This can be done through a small incision in the scrotum or via a minimally invasive approach. Surgery is usually effective, with a low recurrence rate.

In conclusion, while your hydrocele may not currently be causing significant issues, it is essential to monitor it closely. If you experience any changes in symptoms or if the hydrocele continues to recur after aspiration, it would be wise to consult with a urologist. They can perform a thorough evaluation, including a physical examination and possibly imaging studies, to determine the best course of action. Ultimately, the decision to proceed with surgery should be based on your symptoms, the size of the hydrocele, and any underlying factors that may be contributing to the condition.

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