Page 2 - Scrotal Swelling
P. 2
Scrotal swellings
Surgical treatment (hydrocele repair) is appropriate
for most larger and bothersome hydroceles. Under
general (you are “put to sleep”) or spinal (you are
“frozen” from the waist down with a needle in the
back) anesthetic, an incision is made in the front of
the scrotum. The hydrocele is then opened, drained spermatic
cord
and repaired in such a way that the fluid cannot epididymis
re-accumulate. This procedure is usually performed epididymal
as out-patient surgery with return to usual activities in cyst Roula Drossis
testicle
a few weeks. Skin bruising and some scrotal swelling
are not unusual for a few weeks after the operation.
Infection and build-up of blood (hematoma) in the
loose scrotal tissue occurs occasionally and requires
prompt evaluation. Recurrence of the hydrocele may
occur infrequently and require further treatment. Epididymal cysts are variable in size (some may be
larger than the testicle) and, often, cause minimal
symptoms. Treatment for these cysts generally is not
Hydrocele in boys required. Surgical removal is possible for larger and
uncomfortable cysts. This surgery and complications
A hydrocele may be found in a newborn boy. are similar to that of hydrocele repair. With surgery for
Towards the end of pregnancy, each testicle epididymal cysts, there may be some risk of interfering
descends from abdomen into the scrotum alongside with future fertility.
a channel through the groin. This channel normally
closes before or shortly after birth. When the channel
stays open, fluid can run from the abdominal cavity Varicocele
into the scrotum. This is called a communicating
hydrocele. Fluctuation in the size of the hydrocele is A varicocele is a collection of abnormally dilated
common due to back and forth movement of fluid veins in the spermatic cord. The veins that carry blood
from the abdomen to the scrotum. A large hydrocele away from the testicle normally have valves that
may be tense and give a bluish appearance to the prevent back-flow. When these valves are defective,
scrotum but generally should not cause pain. blood may pool in these veins causing engorgement
and dilation, much like varicose veins in the legs.
Often, the communicating channel will close without
treatment before the age of one and the hydrocele Varicoceles are common, occurring in up to 15% of
may disappear. If a hydrocele causes symptoms all men. Varicoceles may vary in size from barely
or persists beyond one year of age, repair may be detectable to very large. They occur most commonly
recommended. Under general anesthesia, an incision on the left side but, in some, both sides are affected.
in the groin allows closure of the connecting channel Many men have no symptoms although some may
and repair of any hernia. This out-patient surgery notice a scrotal swelling that feels like a soft ropy mass
is associated with small risks of bleeding, bruising, or “bag of worms”. The dilated veins will be more
infection and injury to the spermatic cord structures. apparent when standing and they often disappear
when lying down. Some men may experience a mild
aching or heaviness often brought on by physical
Epididymal cysts activity or standing for a long time. Occasionally,
a varicocele will be found in a man during the
Cysts are thin-walled collections of watery fluid that investigation of infertility (difficulty getting his partner
can develop anywhere in the body. When located pregnant).
in the epididymis they are called spermatoceles or
epididymal cysts. The cause of most epididymal cysts
is unknown although some may result from injury or Continued on next page
infection.
