How is hydrocele treated?
Disease description:
My child is now 2 years old. Recently, I noticed that his scrotum appeared slightly swollen. After visiting the hospital, the doctor diagnosed it as hydrocele. I became very worried. How serious is a hydrocele exactly? Is surgical treatment absolutely necessary? What other treatment options are available?
Doctor's answer (1)
Dr. Yang Ziqi
Hydrocele mainly presents as fluid accumulation in the scrotum, leading to scrotal swelling. Depending on the location of the fluid accumulation, it can be classified into different types, including testicular hydrocele, spermatic cord hydrocele, and communicating hydrocele. Treatment of hydrocele should be determined based on its cause, type, and the patient's specific condition. Below are some common treatment approaches:
1. Observation and waiting: For patients with slow progression, minimal fluid accumulation, low tension, no significant symptoms, and no increase in fluid over time—especially infantile hydroceles—the condition often resolves spontaneously before the age of two. Therefore, immediate treatment is unnecessary, and regular follow-up observation is recommended.
2. Medication: If the hydrocele is caused by infection, antibiotics may be used for treatment. Additionally, for hydroceles associated with inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) may be considered to relieve symptoms.
3. Aspiration: Patients with significant fluid accumulation and pronounced symptoms can undergo needle aspiration to relieve symptoms. However, simple aspiration alone has a high recurrence rate. Therefore, following aspiration, a sclerosing agent, such as tetracycline, may be injected into the hydrocele cavity to stimulate an inflammatory reaction and induce adhesion, thereby reducing the risk of recurrence.
4. Surgical treatment: Persistent or recurrent hydroceles, especially communicating hydroceles, are recommended for surgical treatment. Surgical options include traditional open surgery and minimally invasive procedures. The goal of surgery is to remove or close the processus vaginalis to prevent further fluid accumulation.
