Hydrocele: Causes, Symptoms & Surgery in Kathmandu

Hydrocele: Causes, Symptoms & Surgery in Kathmandu

A hydrocele is a collection of fluid around the testicle, causing scrotal swelling. It is one of the most common causes of scrotal enlargement and is highly treatable.

What is a Hydrocele?

A hydrocele forms when fluid accumulates in the tunica vaginalis — the thin pouch surrounding the testicle. It can affect one or both sides.

Types:

• Communicating hydrocele: Connected to the abdominal cavity; fluid flows in and out. Common in infants.
• Non-communicating hydrocele: Isolated fluid collection. More common in adults.

Symptoms

• Painless scrotal swelling (one or both sides)
• Heaviness or dragging sensation in the scrotum
• Discomfort with physical activity
• Swelling that may increase during the day
• Transillumination positive (light passes through the swelling)

Causes

In infants: Failure of the processus vaginalis to close after birth. Often resolves spontaneously by age 2.

In adults:

• Infection (epididymo-orchitis)
• Trauma to the scrotum
• Testicular torsion
• Tumor (rare — always rule out)
• Idiopathic (no identifiable cause — most common)

Diagnosis

• Clinical examination (transillumination test)
• Scrotal ultrasound — confirms diagnosis and rules out testicular tumor
• Blood tests if infection is suspected

Treatment

Watchful waiting: Small, asymptomatic hydroceles in adults may be monitored without treatment.

Aspiration: Draining the fluid with a needle. Simple but high recurrence rate (50–80%). Not recommended as definitive treatment.

Hydrocelectomy (Surgery): The definitive treatment. The fluid sac is surgically removed or everted. Performed under spinal or general anesthesia. Day procedure with excellent outcomes and very low recurrence.

Recovery After Surgery

• Return home same day
• Scrotal support for 2–4 weeks
• Avoid heavy lifting for 2 weeks
• Return to work in 3–5 days (desk job) or 2 weeks (physical work)
• Full recovery in 4–6 weeks

Treatment at GyneNepal

Dr Gorakh Nath Mishra performs hydrocelectomy with excellent outcomes. All consultations are confidential.

Book a consultation or learn more about Male Genital Surgery in Nepal.