Therapy
For the therapy of hydrocele it seems to make most sense to puncture the scrotum with a sterile needle and drain the excess water.However, this is only a symptomatic, and not a causal therapy, meaning that the success is short-lived. Within a few days the water will flow again from the abdominal cavity through the existing connection. In this respect, a puncture can only bring short-term relief, but does not represent a permanent solution.
The therapy options depend on the strength of the hydrocele: For less pronounced, acquired forms, surgery is not necessarily required. As long as they do not represent a limitation due to their size or functional impairment, they can be left in place. However, if this is not the case, the hydrocele must be surgically removed.
There are various surgical procedures for this purpose. The access is usually via the inguinal canal, or directly via a testicular incision on the testicle. The same applies to a congenital hydrocele.
Since there is a risk of a hernia, with subsequent formation of a prolapse of the intestine (a bulge of the bowel) through the junction, and entrapment of the bowel, surgical treatment should be performed. If a section of the intestine becomes trapped, stool may remain in the bowel and the intestine may die. This represents a danger in that the intestine can subsequently decompose and empty its contents into the abdominal cavity. This process is potentially life-threatening.
Prognosis
Since congenital hydrocells often close on their own within the first months of life, surgery is usually not performed during this time. Surgical treatment should only be considered after the age of 3 years. Until this time, the connection between abdominal cavity and scrotum can usually be closed.
Should surgery be necessary, it has a high healing rate. In individual cases, however, relapses (recurrences) may occur, which are then usually treated in the same way. The recurrence rate after hydrocele surgery is comparatively low at 5%. In individual cases, successful puncture may lead to adhesion of the connection: The protein-containing effluent from the abdominal cavity sticks together the opening so that no further fluid can flow. However, this is more likely to happen with small connections and at a young age.
